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Cruz Tax Return 2010

Cruz Tax Return 2010

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10/09/2012

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0-17 1

u..

5

E

Name, Address, and SSN

See separate instructions.
Presidential

and on line 6c are correcl.

L
L...:..V_~~~,,=,,:=!..L..___;~'--___;""!"~~ ~ Check here if you, or your spouse iffiling jointly, want $3 to go to this fund .
..J

Checking

a box below will not

change your tax or refund.

Election Campaign

[XJ

You

[XJ Souse

Filing Status
Check only one box.

1 2 3 6a

D Married filing

CXJ Married filing jointly (even if only one had income)
separately. Enter spouse's SSN above

Single

4

Head of household (with qualifying person). If the qualifying person is a child but not your dependent, enter this child's name here. ~ _

Exemptions

_2_
(",;;i;i.;i"~~.i";;'hll •• lived with you • did not live with you due to divorce (see Instructions)

b~~~~~~~~==~~~~~~~~~~~~~~~~~~~~~~~
c Dependents:
or separation

2
__

dependents, see instructions and check here ..

If more than four

D
7 Wages, salaries, tips, etc. Attach Form(s) W-2 Sa Taxable interest Attach Schedule B if required b Tax-exempt interest Do not include on line 8a 9a Ordinary dividends. Attach Schedule B if required b Qualified dividends 10 11 12 13 14 Taxable refunds, credits, or offsets of state and local income taxes .. Alimony received . Business income or (loss). Attach Schedule C or C-EZ Capital gain or (loss). Attach Schedule D if required. If not required, check here . . ~ . . . . . --' b Taxable amount

Dependents on 6c not entered above

Income
Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld. If you did not get a W-2, see page 20. Enclose, but do not attach, any payment. Also, please use Form 1040-V.

D

Other gains or (losses). Attach Form 4797 IRA distributions 115a 1 b Taxable amount 16a Pensions and annuities .. 16a b Taxable amount 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 15a 18 19 20a 21 Farm income or (loss). Attach Schedule F . Unemployment compensation . Social security benefits 'L2::..;0:,;:;ac....J'L-..... Other income. List type and amount

SEE
Educator expenses

Adjusted Gross Income

24 25 26 27 28 29 31a 32 33 34 35 36

Certain business expenses of reservists, officials. Attach Form 2106 or 2106·EZ

performing

artists,

and fee-basis .

government

.

Health savings account deduction. Attach Form 8889 Moving expenses. Attach Form 3903 One-half of self-employment tax. Attach Schedule SE Self-employed SEP, SIMPLE, and qualified plans Self-employed health insurance deduction Alimony paid IRA deduction b Recipient's SSN ~ --'-_--'_

Student loan interest deduction Tuition and fees. Attach Form 8917 Add lines 231hrough 31a and 321hrough 35
Privacy Act, and Paperwork

S.'l'M'l' 6 .
. " .
Form

Domestic production activities deduction. Attach Form 8903

LHA For Disclosure,

Reduction Act Notice, see separate instructions.

1040

(2010)

\

018711

~-E:!O
Fmm

!'_ ~E_!~'2. ~~E_!:
Application for Automatic Extension of Time To File U.S. Individual Income Tax Return
4 Estimate of total tax liability for 2010
1019

_

4868
E CRUZ TX

1

Your name(s)

$ __

RAFAEL

& HEIDI

S CRUZ

5 Total 2010 payments 6 Balance due. Subtract line 5
7

---':-7_::::O_.::!6:_j,L._7!_O=4...!._. 671 ,7 4 •

°

HOUSTON,

8 Check here if you are 'out of the country" and a U_S. citizen or resident 9
Check here if you file Form 1040NR wages as an employee subject or 1040NR-EZ and did not receive ~ to U.S. income tax withholding

~

D D

Form 1040 (2010)

Tax and Credits

38

Amount from line 37 (adjusted gross income)

.

39a Check {D You were born before January 2, 1946, 0 Blind,} Total boxes it: D Spouse was born before January 2, 1946, 0 Blind. checked... ~ 39a '--==--I b If your spouse itemizes on a separate return or you were a dual-status alien, check here ~ 39b 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 Itemized deductions (from Schedule A) or your standard deduction (see instructions) Subtract line 40 from line 38 . Exemptions. Multiply $3,650 by the number on line 6d . Taxable income. Subtract line 42 from line 41.11 line 42 is more than line 41, enter -0Tax. Check if any tax is from: aD Form(s) 8814 b 0 Form 4972 Alternative minimum tax. Attach Form 6251 . Add lines 44 and 45 .. Foreign tax credit. Attach Form 1116 if required . Credit for child and dependent care expenses, Attach Form 2441 Education credits from Form 8863, line 23 . Retirement savings contributions credit. Attach Form 8880 Child tax credit (see instructions) . .. . .. Residential energy credits. Attach Form 5695 Other credits from Form: a [XJ 3800 b 0 8801 Add lines 47 through 53. These are your total credits line 54 from line 46. If line 54 is more than line . . c0 . . .

---. . 8919 .

enter -04137 b0

Other Taxes

56 57 58 59

Self-employment tax. Attach Schedule SE Unreported social security and Medicare tax from Form: a 0

Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required a0 Form(s) W'2, box 9 b [XJ Schedule H cD Form 5405, line 16 total tax . Federal income tax withheld from Forms W-2 and 1099 2010 estimated tax payments and amount applied from 2009 return . . . . . . . .

Payments

61 62

II you have
a qualifying child, attach Schedule

63 Making work pay credit. Attach Schedule M 64 a Earned income credit (EIC) b Nontaxable combat pay election 65 66 Additional child tax credit. Attach Form 8812 American opportunity credit from Form 8863, line 14 .'

EIC.

67 First-time homebuyer credit from Form 5405, line 10 68 Amount paid with request for extension to file 69 Excess social security and tier 1 RRTAtax withheld 70 Credit for federal tax on fuels. Attach Form 4136 71 Credits from Form: a 02439 b 08839 c 72 Add lines 6

t:1sBo1··;;t:liiB8s······

Refund

Under penalties 01 perjury, I declare that I have examined this return and accompanying and complete. Declaration 01 preparer (other than taxpayer) is based on all information Your signature Joint return? Seepage 12. Keep a copy lor your records. Oate

schedules and statements, and to the best 01 my knowledge 01 which preparer has any knowledge. Your occupation

and

~

Spouse's

signature.

II a joint return,

must sign.

Date

PrinVType

preparer's

name

Check

Paid Preparer Use Only
010002 12-22-10

~~~~~~

_r_.::__::::___:_::....::::.,.+:-

__

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....:..::::.:.:.:.::::::...~~Pf~~-;:;'f;~~_;;;_~~~*.::;:;-;:;;;;;-~~;;-::)n---_f!::l!!:!D~ EXPOSITION BLVD, Firm's address ~ AUSTIN TX 78703

Child Tax Credit Worksheet

X $1,000. Enter the result. line 22, or Form 1040NR, line 37 3. 1040 filers: Enter the total of any• • . } 2_ 3

_;2=...L...:1

Oo_:4=-:0:....L1_;::8--=4c..::.O_:_.

Exclusion of income from Puerto Rico, and Amounts from Form 2555, lines 45 and 50; Form 2555-EZ,

0.

line 18; and Form 4563, line 15. 1040A and 1040NR filers: Enter -0-. 4. Add lines 2 and 3. Enter the total. 5. Enter the amount shown below for your filing status. • Married filing jOintly - $110,000 } • Single, head of household, or qualifying widow(er) - $75,000 • Married filing separately - $55,000 6. Is the amount on line 4 more than the amount on line 5? No. Leave line 6 blank. Enter -0- on line 7. 4 __

=2:...J1,-0=-.=4c_;:0:...L..1..=8-=4=-0=--=-.
-=1=..::1=-=0:....L1_;::0_",0_",_0_=...

5 __

D
[XJ

Yes. Subtract line 5 from line 4..... 6 __ If the result is not a multiple of $1,000, increase it to the next multiple of $1,000 (for example, increase $425 to $1,000, increase $1,025 to $2,000, etc). . .

1~I....::9:...:3:::...:::1.J.I-=0=-0=-=0-=-.
.7

7. Multiply the amount on line 6 by 5% (.05). Enter the result. 8. Is the amount on line 1 more than the amount on line 7? [X] No. STOP

=9-=.6-,-,

.=.5.=.5...=.0_:_.

I

I

You cannot take the child tax credit on Form 1040, line 51, Form 1040A, line 33, or Form 1040NR, line 48.

Form 1040NR, line 44. . 10. 1040 filers: Enter the total of the amounts from lines 47 through 50.*} 1040A filers: Enter the total of the amounts from lines 29 through 32. 1040NR filers: Enter the total of the amounts from lines 45 through 47.* 11. Are you claiming any of the following credits? • • • Residential energy efficient property credit, Form 5695, Part II. Mortgage interest credit, Form 8396

. 10

9

_

D

D

District of Columbia first-time homebuyer credit, Form 8859 No. Enter the amount from line 10. Yes. Complete the Line 11 Worksheet to figure the amount to enter here.

}
.

......... 11 .. 12

_ _

12. Subtract line 11 from line 9. Enter the result. 13. Is the amount on line 8 of this worksheet more than the amount on line 12? No. Enter the amount from line 8. This is your Yes. Enter the amount from line 12. child tax credit.

D

13

* Also include amounts from: Form 5695, line 11 Form 8834, line 22 Form 8910, line 21 Form 8936, line 14 Schedule R, line 22

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SCHEDULE A (Form 1040)
(99)

Itemized Deductions
~ Attach to Form 1040_ ~ See Instructions for Schedule A (Form 1040)_

OMB No. 1545-0074

2010

Medical and Dental Expenses Taxes You Paid

Caution. 1 2 3 5

Do not include expenses reimbursed or paid by others. . . .

Medical and dental expenses (see instructions) Enter amount from Form 1040, line 38 Multiply line 2 by 7.5% (.075) State and local (check : ~ ~:~::,:a;::'t::es only one box): }

S.E.E S.'r.A'l'.E.ME.N.'l' l.O.
. on page 2 (for certain box 5b _ .

6 7 8

Real estate taxes (see instructions) New motor vehicle taxes from line 11 of the worksheet vehicles purchased Other taxes. List type and amount ~ in 2009). Skip this line if you checked

Interest You Paid

10 11

Home mortgage interest and points reported to you on Form 1098 ... S.'r.M'l'...l.4. Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address ~

Note. Your mortgage interest deduction may be limited (see instructions).

12 13 14 16 17 18

Points not reported Mortgage Investment

to you on Form 1098. See instructions (see instructions)

for special rules . .

insurance premiums 10

interest. Attach Form 4952 if required. (See instructions.)

Gifts to Charity
If you made a gift and got a benefit for it, see instructions. Casualty and Theft Losses Job Expenses and Certain Miscellaneous Deductions

Gifts by cash or check. If you made any gift of $250 or more, see instructions Other than by cash or check. If any gift of $250 or more, see instructions. You must attach Form 8283 if over $500 Carryover from prior year . . .

21

Unreimbursed

employee

expenses

- job travel, union dues, job education,

etc.

Attach Form 2106 or 2106·EZ if required. (See instructions.)

~------------------------------------22 23 Tax preparation Other expenses fees - investment, safe deposit box, etc. List type and amount .

~~~Ql1. _K_-J._:: _MQIiG.~ _ _!'~~1~ _~

~Q~~~Up_~~~

~J.~
. . enter -0·

_

24 25 26 27 Other Miscellaneous Deductions 28 Other - from list in instructions. List type and amount Enter amount from Form 1040, line 38 Multiply line 25 by 2% (.02)

~----------------------------------------------29 30 Add the amounts line 40 If you elect to itemize deductions For Paperwork Reduction even though they are less than your standard deduction, see Form 1040 instructions. Schedule A (Form 1040) 2010 in the far right column for lines 4 through 28. Also, enter this amount on Form 1040,

Total Itemized Deductions
LHA
019501

12-21-10

Act Notice,

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Schedule Worksheet

A (Form 1040) 2010 Before you begin: " " You cannot take this deduction ($260,000 if married filing jointly). See the instructions for line 7 on page A6. if the amount on Form 1040, line 38, is equal to or greater than $135,000

Page 2

for Line 7 New motor vehicle taxes

Enter the state or local sales or excise taxes you paid in 2010 for the purchase of any new motor vehicle(s) after February 16, 2009, and before January 1, 2010 (see instructions) .

Use this worksheet to figure the amount to enter on line 7.

2 Enter the purchase price (before taxes) of the new motor vehicle(s) 3 Is the amount on line 2 more than $49,500? DNo. DYes. Enter the amount from line 1. Figure the portion that is attributable of the tax from line 1 to the first $49,500 }

2

(Attach to Form 1040.)

of the purchase price of each new motor vehicle and enter it here (see instructions). 4 Enter the amount from Form 1040, line 38 5 Enter the total of any • Amounts and • Exclusion of income from Puerto Rico . from Form 2555, lines 45 and 50; 15, Form 2555·EZ, line 18; and Form 4563,line

}
A,

.

6 Add lines 4 and 5 7 Enter $125,000 ($250,000 if married filing jointly)

6
1--'7'---jf-_

8 Is the amount on line 6 more than the amount on line 7? D D No. Yes. Enter the amount from line 3 above on Schedule line 7. Do not complete Subtract the rest of this worksheet. line 7 from line 6

9 Divide the amount on line 8 by $10,000. Enter the result as a decimal (rounded to at least three places). If the result is 1.000 or more, enter 1.000 10 Multiply line 3 by line 9 for new motor vehicle taxes. Subtract . . line 10 from line 3. Enter the result here Schedule A (Form 1040) 2010 .

11 Deduction

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2010.03060

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SCHEDULE B
(Form 1040A or 1040)
(99)

Interest and Ordinary Dividends
~ Attach to Form 1040A or 1040. ~ See instructions.

1

List name of payer. If any interest is from a selfer·financed property as a personal residence, buyer's social security number and address ~

mortgage and the buyer used the _

see page 8·1 and list this interest first. Also, show that

Note. If you received a Form 1099·INT. Form 1099·010, or substitute statement from a brokerage firm, list the firm's name as the payer and enter the total interest shown on that form.

AMERICAN EXPRESS BANK, FSB BANK OF AMERI CA GOLDMAN SACHS & CO. ING DIRECT UNIVERSITY FEDERAL CREDIT UNION FROM K-1 - MORGAN, LEWIS & BOCK IUS LLP FROM K-1 - ENTERPRISE PRODUCTS PARTNERS

SUBTOTAL FOR LINE 1 TAX-EXEMPT INTEREST
2 3 Add the amounts on line 1 Attach Form 8815 .. __ __ __ .. __ .__ __

SEE STATEMENT

13
. .

Excludable interest on series EE and I U.S. savings bonds issued after 1989.

Part II Ordinary Dividends

5

List name of payer

~

THE GOLDMAN SACHS GROUP, INC. GOLDMAN SACHS & CO. FROM K-1 - MORGAN, LEWIS & BOCKIUS

LLP

Note: If you received a Form 1099·DIVor substitute statement from a brokerage firm, list the firm's name as the payer and enter the ordinary dividends shown on that form.

5

Part III Foreign Accounts and Trusts
8 LHA For Paperwork

b
During 2010, did you receive a distribution If Reduction Act Notice, see separate from, or were you the grantor of, or transferor 8·2 Schedule B (Form 1040A or 1040) 2010 to, a foreign trust? have to file Form 3520. See instructions.

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SCHEDULE D (Form 1040)
Department of the Treasury Internal Revenue Service Name(s) shown on return

Capital Gains and Losses
~ Attach to Form 1040 or Form 1040NR. ~ ~ See Instructions transactions for Schedule 0 (Form 1040). Use Schedule 0-1 to list additional for lines 1 and 8.

(e)

Costar other basis

(f) Gain or (loss) Subtract (e) from (d)

u612.90 SHS GOLDMAN H YIELD INSTL 569.48 SHS GOLDMAN SACHS HIGH ELD MUTUAL FD

2
3 4

Enter your short-term totals, if any, from Schedule 0·1, line 2 Total short-term sales price amounts. . . . in the instructions .. Add lines 1 and 2 in column (d) Short-term gain from Form 6252 and short-term gain or Qoss) from Forms 4684, 6781, and 8824 Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule{s) K·1 Short-term capital loss carryover. Enter the amount, if any, from line 10 of your Capital Loss Carryover Worksheet

5
6

(a) Description of property (Example: 100 sh. XYZ Co.)

(c)

Date sold (Mo., day, yr.)

(d)

Sales price

(e)

Costar

other basis

(f) Gain or ~oss) Subtract (e) from (d)

8

9 10 11 12 13

Enter your lonq-term totals, if any, from Schedule D·1, line 9 Total long-term sales price amounts. Add lines 8 and 9 in column (d) Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) from Forms 4684, 6781, and 8824 Net long-term gain or (loss) from partnerships, from Schedule(s) K-1 Capital gain distributions Carryover Worksheet capital in the instructions

.. . .

S corporations, estates, and trusts

S.E.E. S.'r..l;,'r.E.~E.N'r...J.4

.
.

-17.

15 LHA

Net long-term

gain or (loss). Combine lines 8 through 14 in column (f). Then go to Act Notice, see your tax return instructions. Schedule 0 (Form 1040) 2010

For Paperwork

Reduction

020511

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15211006 786859 CRUZ

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16

Combine lines 7 and 15 and enter the result • • • If line 16 is a gain, enter the amount from line 16 on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 17 below. If line 16 is a loss, skip lines 17 through 20 below. Then go to line 21. Also be sure to complete line 22. If line 16 is zero, skip lines 17 through 21 below and enter -0- on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 22.

17

Are lines 15 and 16 both gains? DYes. D Go to line 18. No. Skip lines 18 through 21, and go to line 22. if any, from line 7 of the 28% Rate Gain Worksheet on page 0-8 of the ~ if any, from line 18 of the Unrecaptured Section 1250 Gain Worksheet on . 19

18

Enter the amount, instructions ,

19

Enter the amount,

page 0-9 of the instructions 20 Are lines 18 and 19 both zero or blank?

D Yes.

Complete

Form 1040 through line 43, or Form 1040NR through line 41. Then complete and Capital Gain Tax Worksheet in the Instructions for Form 1040,line for Form 1040NR, line 42). Do not complete on page 0-10 of the instructions. lines 21 and 22 below. lines 21 and

the 44

Qualified D

Dividends

(or in the Instructions No. Complete Schedule 22 below. 21

Form 1040 through line 43, or Form 1040NR through line 41. Then complete the Do not complete

0 Tax Worksheet

If line 16 is a loss, enter here and on Form 1040,line • • The loss on line 16 or ($3,000), or if married filing separately, ($1,500)

13, or Form 1040NR,line

14, the smaller

of:

}

S.E.E S.T~TEJ~E.NT
as positive numbers.

rs

.

21

Note. When figuring which amount is smaller, treat both amounts 22 Do you have qualified dividends

on Form 1040, line 9b, or Form 1040NR, line 10b? the Gain Tax Worksheet in the Instructions for Form 1040, line 44

[XJ

Yes. Complete Qualified

Form 1040 through line 43, or Form 1040NR through line 41. Then complete and Capital for Form 1040NR, line 42).

Dividends

(or in the Instructions D No. Complete

the rest of Form 1040 or Form 1040NR. Schedule 0 (Form 1040) 2010

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Qualified Dividends and Capital Gain Tax Worksheet - Line 44
Name(s) shown on return

Keep for Your Records

Before you begin:

j j

See the instructions

for line 44 on page 35 to see if you can use this worksheet

to figure your tax. be sure you

If you do not have to file Schedule 0 and you received capital gain distributions, checked the box on line 13 of Form 1040.

1.

Enter the amount from Form 1040, line 43. However, if you are filing Form 2555 or 2555·EZ (relating to foreign earned income), enter the amount from line 3 of the worksheet on page 36 2. 1.

_--=l..L -=.8-=1-=1...L,-=.6-=1_,;:.6_:_.
l

2. 3.

Enter the amount from Form 1040, line 9b* Are you filing Schedule

..:::5:...L., ""1:,:1".,3,,,--,,-.

O?'
} ...

[XJ

Yes.

D No.
4. 5.

Enter the smaller of line 15 or 16 of Schedule D. If either line 15 or line 16 is blank or a loss, enter ·0· Enter the amount from Form 1040, line 13

3

• --

°

.=:....:-.

Add lines 2 and 3 If filing Form 4952 (used to figure investment interest expense deduction), enter any amount

4.

5=-..L,-=1::...:1=-3~.

from line 4g of that form. Otherwise, enter ·0· ... 5. 6. 7. 8. Subtract Subtract Enter: $ 34,000 if single or married filing separately, $ 68,000 if married filing jointly or qualifying $ 45,550 if head of household. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Enter the smaller of line 1 or line 8 Enter the smaller of line 7 or line 9 Subtract line 10 from line 9. This amount is taxed at 0% Enter the smaller of line 1 or line 6 Enter the amount from line 11 Subtract line 13 from line 12 Multiply line 14 by 15% (.15) widow(er), line 5 from line 4. If zero or less, enter ·0· line 6 from line 1. If zero or less, enter ·0·

O;:_::_.

6.

---=5-'-'-=1-=1=3_:_.

}

7.

_--,1=-<--.;' 8::....;0:....;:6:....1.1--=5--=°-=3".:... ....::6-=8-'-,--=:0--=:0--=:0-=-.
-=:6-=8-'-'-=0-=0-=0-=-. _,;:.6_,;:.8_,_,....::0....::0....::0_:_.

.

8.

9.
10. .. 11. . 12. 13. 14.

~~~0~.
---'5=-.11

=1=1=3".:..'

--=---:-..,.....".0".:...

5,113.
. 15. use the Tax Table to Worksheet use the Tax Table to Worksheet . 18. . 16. 17.

767.
602l584.

Figure the tax on the amount on line 7. If the amount on line 7 is less than $100,000, figure this tax. If the amount on line 7 is $100,000 Add lines 15 and 16 Figure the tax on the amount on line 1. If the amount on line 1 is less than $100,000, figure this tax. If the amount on line 1 is $100,000 Tax on all taxable income. Enter the smaller or more, use the Tax Computation or more, use the Tax Computation

603,351.
604l374.

of line 17 or line 18. Also include this amount on Form . 19 • this line.

1040, line 44. If you are filing Form 2555 or 2555·EZ, do not enter this amount on Form 1040, line 44. Instead, enter it on line 4 of the worksheet on page 36

603l351.

• If you are filing Form 2555 or 2555-EZ, see the footnote in the worksheet on page 36 before completing

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Sale of Your Home
Part 1- Gain (or Loss) on Sale 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Selling price of home Selling expenses Subtract Adjusted Subtract line 2 from line 1 basis of home sold. . line 4 from line 3. This is the gain (or loss) on the sale. If this is a loss, stop here claimed on the property for periods after May 6, 1997. If none, enter zero use after 12/31/08 . . . . . . . . . . by line 10) .. . .. .. Section 1250 ..

1,060,000. 70,660. 989,340. 1,050,000.

o.

Part 2- Exclusion and Taxable Gain Enter any depreciation Subtract Aggregate line 6 from line 5. (If the result is less than zero, enter zero.) number of days of nonqualified

Number of days taxpayer owned the property Divide the amount on line 8 by the amount on line 9 Gain allocated to nonqualified Gain eligible for exclusion. Maximum exclusion Subtract use. (Line 7 multiplied Exclusion Subtract line 11 from line 7 Worksheet)

(From Reduced

Enter the smaller of line 12 or line 13. This is your exclusion line 14 from line 5. This is your taxable gain D Enter the smaller of line 6 or line 15. Enter this amount on line 12 of the Unrecaptured Gain Worksheet for Schedule

Reduced Exclusion Worksheet
You 1. Maximum amount................................................. 5·year period ending on the date of sale b. Enter the number of days that you owned the property during the 5·year period ending on the date of sale c. Enter the smaller of line 2a or 2b 3. Have you (or your spouse if filing jointly) excluded gain from the sale of another home during the z-year period ending on the date of this sale? NO. Skip line 3 and enter the number of days from line 2c on line 4. YES. Enter the number of days between the date of the most recent sale of another home on which you excluded 4. 5. 6. 7. Enter the smaller of line 2c or 3 gain and the date of sale of this home . . . .. .. line 13 .. .. .. .. . .. Your Spouse

2a. Enter the number of days that you used the property as a main home during the

Divide the amount on line 4 by 730 days. Enter the result as a decimal Multiply the amount on line 1 by the decimal amount on line 5 Add the amounts exclusion. in both columns of line 6. This is your reduced maximum Enter it here and on Sale of Your Home Worksheet,

Selling Expenses

Adjusted Basis of Home Sold

EXPENSES OF SALE

70,660. BASIS

1,050,000.

TOTAL TO LINE 2
003606 01-13-11

70,660.

TOTAL TO LINE 4

1,050,000.

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SCHEDULE (Form 1040)

E

Supplemental Income and Loss
(From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.)
(99) ~

OMS No. 1545-0074

Department of the Treasury Internal Revenue Service

2010
Attachmen~o.13

Attach to Form 1040, 1040NR, or Form 1041.

~

See Instructions for Schedule E (Form 1040).

Name(s) shown on return

Your social security number

or

Note. If you are in the business of renting
Yes No

Schedule C or C-EZ (see page E-3). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40. 1 List the type and address of each rental real estate property: 2 For each rental real estate property listed on line 1, did you or your family use it A CONDO during the tax year for personal purposes 3333 ALLEN PKWY UNIT 2606, HOUSTON, TX 77 for more than the greater of: B RENTAL HOUSE 14 days or 1510 HARTFORD RD, AUSTIN TX 78703 10% of the total days rented at fair C rental value? (See page E-4)

A
B C Totals

X X

• •

Income:
3 Rents received ....... 4 Royalties received ....
- .. - ..............................
............. _ .. __ .......... _w ....

Properties

A 3

B
1

C

(Add columns A, S, and C.) 3

29 703.

16,683.

46 386.

4
5 6
7

4

Expenses:
5 Advertising .... .... - .................... __ ...... - - ........ 6 Auto and travel (see page E-5) .....................
7

Legal and other professional fees .................. Management fees ........ .............................. Mortgage interest paid to banks, etc. (see page E-5) ......... ................................ 13 Other interest ........... ......... ....................... 14 Repairs ..... ..................... . ... ... ... . .. . . ..... . .. 15 Supplies. ................................................. 16 Taxes ................................................ Utilities ...... .......... . . . . . ........ .. .. ................ 18 Other (list) ~
17

8 9 10 11 12

Cleaning and maintenance ........................... Commissions ... ........................................ Insurance
....... ............... . ......................

8 9 10 11 12 13 14 15 16
17

200. 2 600.
1

1,633. 138. 1 925. 19 983.
1

14,968. 1,092. 5 061. 6 536.

12

34 9511

2,485. 11, i ai .
I

SEE STATEMENT

16
18

I>

Ii
L.

19 Add lines 5 through 18 ................................. 20 Depreciation expense or depletion (see page E-5) 21 Total expenses. Add lines 19 and 20 ............... 22 Income or (loss) from rental real estate or royalty properties. Subtract line 21 from line 3 (rents) or line 4 (royalties). If the result is a (loss), see page E-6 to find out if you must file Form 6198 .................. 23 Deductible rental real estate loss. Caution. Your rental real estate loss on line 22 may
Uv """,vu.

19 20 21

30 457. 13 673. 44 130.

37,285. 10,909. 48,194.

I

:',

,

19 20

67,742. 24 582.
1

22

-14 427.

-31

sn .

X

,

'"

,

.

.:

'ii"
...•..

o . r C' Vvv PUll v L v 'v ""u

vu,

,.yvu

23 24 Income. Add positive amounts shown on line 22. Do not include any losses .... ... .................. ......................... . .. .. .. . . ... ... . . . 25 Losses. Add royalty losses from line 22 and rental real estate losses from line 23. Enter total losses here ................................. 26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. If Parts II, III, IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 1040NR, line 18. Otherwise, include this amount in the total on line 41 on page 2 ........
021491 03-21-11

must file Form 8582. Real estate professionals must complete line 43 on page 2 .........••.•.....

o.

o.

~

24 25

(

o.

0,)

.................................

26

o.
CRUZ 1

LHA

For Paperwork Reduction Act Notice, see instructions.

Schedule E (Form 1040) 2010

15211006

786859

CRUZ

2010.03060

13 CRUZ, RAFAEL

E

Attachment not enter name and on page 1.

1~l:Irtll•• I
27

Income or Loss From Partnerships and S Corporations Note. If you report a loss from an at-risk activity for which any amount is not at risk. you must check column (e) on line 28 and attach Form 6198. See page E-2.
DYes

Are you reporting any loss not allowed in a prior year due to the at-risk or basis limitations, a prior year unallowed loss from a

[X]

No

28

(e) Check if any amount is not at risk

(g) Passive income from Schedule K-1

(h) Nonpassive loss from Schedule K-1

29a b 30 31 32

Totals Totals Add columns (g) and (j) of line 29a . Add columns (f), (h), and (i) of line 29b . Total partnership and S corporation income or (loss). Combine lines 30 and 31. Enter the line 41 b (b) Employer identification number

33

(a) Name

(d) Passive income from Schedule K-1

34a b 35

Totals . Totals . Add columns (d) and (f) of line 34a

Net farm rental income or (loss) from Form 4835. Also, complete line 42 below 42 Reconciliation of farming and fishing income. Enter your gross farming and fishing income reported on Form 4835, line 7; Schedule K-1 (Form 1065), box 14, code B; Schedule K-1 (Form 1120S), box 17, code U; and Schedule K-1 (Form 1041), line 14, code F (see page E-8) 43 Reconciliation for real estate professionals.
enter the net income activities in which or (loss) you reported anywhere under the If you were a real estate professional (see page E-2), on Form 1040 or Form 1040NR from all rental real estate

.

021501 03-21-11

Schedule E (Form 1040) 2010

15211006

786859 CRUZ

2010.03060

14 CRUZ, RAFAEL

E

CRUZ

1

INCOME SCHEOULEE Name

FROM PASSTHROUGH

STATEMENT,

PAGE 1 SSN/EIN ___

2010

RAFAEL

E CRU2
LEWIS

Passthrough

MQRGAN

&

LLP

10 Prior Year Unallowed Disallowed Due to Basis Loss Basis Limitation

23-0891050
Prior Year Unallowed Disallowed Due to At-Risk Loss At·Risk Prior Year Passive Loss Disallowed Passive Loss

PARTNERSHIP MmJt>r.~"lIVE
SCHEDULE E, PA 3E2 loss) ......... K-1 Input

TAXPAYER

I

Tax Return

Ordinary business income

1.402.293

Rental real estate income (I ass) ......... Other net rental income (IOl s) ............ Intangible drilling costs/dry Self'charged Guaranteed payments Ihole costs passive intere ~t expense
....

ii.
[!.i··/.· ••..
....

I

............... Section 179 and carryover ............... Disallowed section 179 ""1-' 'I ",., ...... Excess farm loss ........ " ... ...............
Net income (loss) ............. First passive other Cost depletion

3198"1
1 722 182

L', , ~

i, "r,C~S~i~"!~;*"'U">
.. '

'.

'.'

[

.

~iiii/>...

li· ..ii.· .....·.·i < ·i.i'o(/

".iii
............ ·..........

!>i
•......
.:':

f·' •
1.722.182

...............
...............

..........

Second passive other .......

................ ................ ............... Percentage depletion ....... ................ Depletion carryover .......... ................
Disallowed due to 65% Unreimbursed
111111 1"!lUI

......
'vl

expenses I' other ............. E {paQe 2\ FORM 4797

'I-'CO"

Nonpassive I

................

Total Schedule

-4.000 1 718.182

-4.000 1 718 182

Section 1231 gain (loss) ....

...............
.''0»> ••. >

I

Section 179 recapture on ...I~~~~;+;~n

~=""""III_EC
cap. gain (10 ~s)

!> .....••..•..
-17

Net short-term Section 1256 I Investment

Net long·term cap. gain (los ~)
,",VI!"

......... ............

-17

,&5

raooies

FORM4952 interest expens ·Sch.A

!J.••...•..•• ,•••.••.•.•.•..••..•••.•••... : .•.•...... /r<i.····.

h.·•...• ·.

··i·

,
.

...

I

•incorr e Other net IT .......17I=n OEOUC· rUN::; ....
IJVI '"

!'.i:j«·.·.·.···

t,····> •.····.1i?· :·.··,·.··.··.·,.··.·· < ••'•.... ••••.•• ••.. ·.>i.....'
739
11

••••.••••..••••.• ' •.•.•.• /"'
.•

.:

.>

'.

..
739 _11 55.011

Charitable contributions Deductions related to Other ..........................

. ...... .......
~i;vincome

" ...

...............

55011

021551 03-03·11

15

INCOME SCHEDULEE Name RAFAEL E CRm MORGAN ~EWIS &
J:lO("KTTT~

FROM PASSTHROUGH

STATEMENT,

PAGE 2 SSN/EIN ___ TAXPAYER Prior Year Passive Loss Disallowed Passive Loss

2010

Passthrough PARTNERSHIP °ll.SSIVE

LLP

10 Prior Year Unallowed Disallowed Due to Basis Loss Basis Limitation

23-0891050
Prior Year Unallowed Disallowed Due to At-Risk Loss At-Risk

1\TI"\1\T

K-1 Input AND DIVI PENOS

Tax Return

r

INTEREST

Interest income ................ Interest from U.S. bonds Ordinary dividends Qualified dividends Tax-!:IJI!:IlIllJl interest

................
· ......•.........

4

4

..

,

....... ................

r

... ... . .. . . . ... . income ...
.......... af ler 12/31/86

FORM 6251 adjustment

Depreciation Adjusted Beneficiary's Other

gain or loss

....... ................
......... · ................

AMT adjustm ,nt

Depletion (other than oil)

I

MISCEL

I

AII,JEO~S Ivs,,)I''''a~es

Self-employment Royalties

eamings

Gross farming & fishing inc .........................

Royalty "'''I,'''' I Undistributed capital gains credit Backup withholding .........

............... ................ ............
......

-2 562 2

2 562 2
."

I,;'i.<;'i.,:·.·.·} ..•.• ~T·=----. ·•

L',,_

.;'

.

. ".

-346

-78

-346 -78

1::1'"%2/

'i)

i;';)Y

..••... ·~

.. p-c: •.....
'

.

.
1.759.161

1.759.161

................ Credit for estimated tax ... ................ Cancellation of debt ..." . ................ Medical insurance - 1040 · ................ Dependent care benefits ................ Retirement plans ................ Qualified production activities i come ......
Passthrough NOL Credits adjustment to Form 1040 of savings

,

..

r

Penalty on early withorawa Other taxes/recapture

.............................. · ................
of cr ~dits .........

........................... · ................

1 210

1.210

Casualty and theft loss ....................

021552 05-01-10

16

INCOME SCHEDULEE Name Passthrough

FROM PASSTHROUGH

STATEMENT,

PAGE 1 SSN/EIN ___

2010

Rl\FAEL E cao: rr ~F. TRADED PA..

t> ..

D

"'"...,.t> "

10 Prior Year Unallowed Disallowed Due to Basis Loss Basis Limitation

PUBLICLY OTHER
I

76-0568219
Prior Year Unallowed Disallowed Due to At-Risk Loss At-Risk Prior Year Passive Loss Disallowed Passive Loss

TAXPAYER

PASSIVE
~_ ._~JLE E,PA ~2 ~oss) .... ,_,..

K-1 Input

'i·(',·

•.... '.
-2.001

Tax Return

Ordinary business income

Rental real estate income (I pss) ......... Other net rental income (losIs) ............ Intangible drilling costs/dry Ihole costs Self-charged Guaranteed passive intere ~t expense payments

Section 179 and carryover

.... ................ ............... Disallowed section 179 ""t"'''''''' ...... Excess farm loss ... ........ . ................ Net income (loss) ............ ................ First passive other .. .. ..... . ................ Second passive other. "'''' ................ Cost depletion ................ ................ Percentage depletion ...... ............... Depletion carryover ......... ...............
Disallowed due to 65% Unreimbursed Nonpassive Total Schedule expenses other ............ E (page 2) FORM 4792
...............
111111 tauor

I

..

I

~ii~'t(
-2 001

tr;t'i

·.: i .,•. '·ii' ." ..•....

....'.}i,?7·~ I·······i'·

.............•.....
.
'.

;

1.314

3 315

......

{I

'1-'<>.,,, ""

...............

r
I

;i.'
/if ..··» ·.
.........

.• ·»·

-2.001

".
-3<;

...... i<

1 314 37

3 315 72

Section 1231 gain (loss) '" Section 179 recapture on SCHEDULE D Net short-term Section 1256 I Investment

.......

'i

cap. gain (10 ~s)

Net long-term cap. gain (los ~)

............

""<1,,''''
FORM49s2

& s lraddles '" -Sch.A

1'" ..•••• '...;> •••.•• >
t'<' .'. iii
....... >i

f ••··• ·
f

interest """''''

Other net : incon e ITEIIJI171=n DEDUC- IONS I Charitable contributions Deductions Other ....

'.

.............. ...............

related to portf ~Iio income

...............................

021551 03-03-11

17

INCOME FROM PASSTHROUGH STATEMENT, PAGE 2 SCHEDULE E Name RAFAEL E CRUl IT ~F. Passthrough
PUBLICLY
PROntTl"'Tl'l
t:>

2010 SSNIEIN __

--K·1 Input
13

10

76-0568219 Prior Year Passive In Loss
.11.

TAXPAYER

TRADED FA. ~TNERSR:::P

I

OTHER PlI.SSIVE
IN I t;Ht;l:;"

AND

UIV

Interest income ....... ....... ................ Interest from U.S. bonds ................ Ordinary dividends

_ .. .-

-

Prior Year Unallowed Disallowed Due to Prior Year Unallowed Disallowed Due to Basis Loss Basis Limitation At-Risk Loss At·Risk

Passive Tax Return
'.'

c..... " ....... '" '.'

.... ......... ,..

-v. •;'

> ..'..

,",,<"

.:

..

........

.:",

"

.....

..

•••••••••

"

.

13

......... ................ =

I

Qualified dividends ........ ............... T: interest incorm FORM 6251

=

~
403 403

Depreciation adjustment a1ter 12/31/86 Adjusted gain or loss ...... . ... . ....... ... . Beneficiary's AMT adjustm pnt ......... Depletion (other than oil)

................
k'... ·· ..

I

Other
MI~~r:1 I

AIllEO I,S

».,.~

. :.·.·.·;i··· .:•• i..·..................... ·............ [7-00·····.·.·.•. I..i ···

..• ..

.

••••

Self·employment earnings ~u::;s)/WQyes Gross farming & fishing inc ............... Royalties .......................

...............

Royalty ""1-'''' Undistributed capital gains credit ...... Backup withholding .......... ............... Credit for estimated tax ... · ................ Cancellation of debt ....... ............... Medical insurance- 1040 ............... Dependent care benefits · ................ Retirement plans ............. ............... Qualifiedproduction activities lhcome ...... Passthrough adjustment tc Form 1040 Penalty on early NOL
'1lIIUIClVVCI

of savings

.............................. · ................

of CI :edits ......... Credits ......... . ... . ....... .. . .. . · ................ Casualty and theft loss . . .. ................

Other taxes/recapture

021552 05-01-10

18

Schedule E
RAFAEL E & HEIDI S CRUZ

_P~SSTHROUGH

RECAP

~!C_INFOR~AT~IJN

T ,J

Sch~dule K-1 Lin •Reference: UO~/1120S/1041) Entity No. 2 4 Act No. 2 3
MORGAl
!;'1\T"'l:'~.

1/1/6 Ordinary Income (Loss)

2/2!1

3/3/8

*

~~

Name
LEWIS "USE
& J:!UI..:K. J:; LLP
"l'l~'1'1ITl:'~!:!

Rental Real Other Rental Estate Income lnc.ttoss) (Loss)

L~~~v~~o 1 314

~~~iat~~~
5/4/1 Interest 990 4 13

_6~a/2a Dividends 2.562

7/6/* Royalties
I

8/7/3
Short-Term Capital

US Treasury Bond Interest

--~~.

4/*/*

Net Long-

Guaranteed Payments to Partner

~erm Capital

TP TT

Gain (Loss)

I

Gain (Loss)

H02293 -2.001

_-:-ll 319889

Totals ............................... Component of:

...................................................

1400292
Schedule E, Page 2, Various Schedule E, Page 2, Schedule E, Page 2,

Various

Various

1 314 Form 8582 Line 3c

.t9rm

990

Line 3c

2.562 17 Schedule B, Schedule B, Schedule B, Line 1 Line 1 Line 5

-17
ScheduleE, Line 4 Schedule LineS D, Schedule Line 12 D,

319889 I Schedule E,
Page 2,

Various

Schedule K-l Line Reference:
ve

t)

10/9/* ISection 123 Gain (Loss) -35

*

11/10/* Other Income

13/121* ~ont~~~otions 739

12/11/* Section 179 Expense

13/12/*
Related to Portfolio Income (2%)

13/12/* Other Deductions 4.000

13/12/*

*/*

20/17/14

13/*/* SE Health Insurance Premium

*
Wages for More Than 2% Shareholders

14/*/* Net SE Earnings '1759161

17/15/12
AMTDepr Adj on Post 1'86 Prooerty

*/*/12
Minimum
Tax Adiustment

*/*/12 Exclusion Items

Entity No. 2 4

Act. No. 2 3

~~~~(~~t~

Investment Investment Int. Expense 11~;~h~~U~~~~ Income 'S~II~UUI~ A) IISch; ule E) 2 566 13

11

-346 40~_

Totals ......... Component of:

-35 Form 4797, Form 4797, Line 10

Schedule Page 2,

E,

739
Schedule A, Lines 16 & 17

11

Various

Form 4562, Schedule A, Line 6 Line 23

Schedule

4 000
E,

Page 2,

Various

Schedule A, Line 14

Schedule Page 2,

E,

Various

2 579 11759161 Form 4952, Form 1040, Form 1040, ~chedule SE. Line 4a Line 7 Line 29 line 2

57
Form 6251, Line 19 Form 6251, Line 16

2010 Form 8801

* - No specific Schectne 1\-1 line reference for these amounts,
028071 05·01-10

18.1

Schedule

E

PASSTHROUGH

RECAP - ADDITIONAL

INCOME,

DEDUCTIONS,

AND PRIOR YEAR CARRYOVERS

RAFAEL E & HEIDI S CRUZ
Schedule K-1 Line Reference: (1065/1 120S/104 1)

17/15/* AMT Adj. Gain or Loss -78

15/13/13

15/13/*

*/*/10 Estate Tax Deduction

*/*/11
Excess Deductions on Termination

18/16/14 Tax-exempt Interest Income

18116/* Other Tax-exempt Income

18/16/* Nondeductible Expenses 5 582 2

* Section 1231 PAL Carryover 37

*
AMT Section 1231 PAL Carryover

Entity No. 2 4

Act No. 2 3

Low Income Low Income Housing Cr Housing Cr Pre '08 Post '07

* ST Capital PAL C/O

* AMT ST Capital PAL C/O

*

*

AMT Form 4797 AMT 4797 LT Capital LT Capital Ordinary Ordinary PAL C/O PAL C/O PAL C/O PAL C/O

*

2010

*

37

Totals Component of:

78 Form 6251, Line 18

5 584.

37

Form 8586 Line 4

Form 8586 Line 11

Schedule A, Schedule A, Schedule S, Schedule S, Line 28 Line 23 Line 1 Line 1

Form 6198, Line 4 Basic Lmt.

Form 8582, Line 3c

Form 8582 AMT, Line 3c

37

Form 8582, Line 3c

Form 8582 AMT, Line 3c

Form 8582, Line 3c

Form 8582 AMT, Line 3c

Form 8582, Line 3c

Form 8582 AMT, Line 3c

Schedule K- 1 Line Reference: (1065/1 120S/104 1)

*/* Section 179 Carryover

13/121*
Charitable Contributions 30% Regular

13/12/*
Charitable Contributions 30% Special

13/12/*
Charitable Contributions 20%

13/*/* Keogh Payments

13/*/* SEP Payments

13/*1*
IRA Contribution s

11/10/5 Other Portfolio ncome (loss

*
Other Nonportfolio Nonpassive

9c/8c/4c

20/171*

*
Investment Interest Expense (Sch. E)

*/*/9
Nonpassive
Depreciation and

13/121*
~eductlons Related to Portfolio (not2%)

*
Medical Payments for

Entity No. 2

Act No. 2

income

Unrecaptured Section 1250 Investment Expenses Gain 11

c/o

Amortization

Income

2% Owner

Totals

.........

Component

of:

Form 4562, Line 10 *

Schedule Lines 16&

A, 17

Schedule

A,

Schedule

A,

Lines 16 & 17

Lines 16 & 17

Form 1040, Line 28

Form 1040, Form 1040, Line 28 Line 32

Schedule E, Page 2,

Various

Schedule E, Page 2, Various

11 Schedule D, Form 4952, Form 4952, Line 19 Line 5 Line 2

Schedule Line 33

E, Schedule Line 28

A, Schedule Line 1

A,

026072

05-01-10

-

No sp cific Schedule K-1line reference for these amounts.

18.2

Schedule RAFAEL

E E & HEIDI S CRUZ

~,..s., ~OUGH

RECAP

ADDITIONAL

INl"vl"IlVIATION AND PRIOR~

AT-RISK

CARRyOVER::;

Schedule K-1 Line Reference: (1065/1120S/1041)

~
9b/8b/4b
Net LT Capital Gain (loss) 28%

*
Form 4684 Casually or Theft Gain (loss)

15/13/13

*

*/*/13 Estimated Tax Paid bv a Trust

15/13/13
Qualified Rehabilitation Expenditures Credit

15/13/13 Alcohol Fuel Credit

15/13/13
Nonconventional Source Fuel Credit

15/13/* Patrons Credit

15/13/13 Welfare to Work Credit

15/13/13

17/15/12
Form 6251 Depletion (Not Oil and Gas)

17/15/*
Form 6251 Interest Deduction

17/15/*
Form 6251 Incentive Stock Options

17/15/*

17/15/* ;1
;::x~:t Interest P.A. Bonds

Entity No, 2

Act Na_ 2

Federal State Income Tax Income Tax Withheld Withheld 55011

I OP~~~~~ity

i

Form Activities

."',

Totals ......... Component of:

Schedule 0, Form 4684, Line 18 Section B

Form 1040, Line 61

55 011 Schedule A, Form 1040, Line 5 Line 62

Form 3468, Line 10

Form 6478, Line 7

Form 8907, Line 12

Form 5884, Line 3

Form 8861, Line 3

Form 5884, Line 3

Form 6251, Line 10

Form 6251, Line 9

Form 6251, Line 15

Form 6251, Line 20

Form 6251, Line 13

Schedule K-1 Line Reference: 1)

* Schedule E At-Risk Carryover

*
AMT Schedule E At-Risk _Carryover

* ST At-Risk

* AMT ST At-Risk
~cver

.
LT C~~;~~~~r

* AMT

.
sec, 1231
At-Risk Carryover

.
AMT Sec. 1231 At-Risk Carryover

* 4797-0rd_ At-Risk Carryover

*
AMT 4797-0rd. c~~~~~ker

.
Ic
Other At·Risk
YUy",,;)

*
AMT Other At- Risk Carryovers

Entity No.

Act. No.

~

~:~~~~~~

Totals

.........

Component

of:

Form 6198, Line 1

028073

05-01-10

.

61:;';'MT, Line 1

Form 6198, Line 2a

Form 6198 AMT, Line 2a

Form 6198, Line 2a

Form 6198 AMT, Line 2a

Form 6198, Line 2a

Form 6198 AMT, Line 2a

Form 6198, Line 2b

Form 6198 AMT, Line 2b

Form 6198, Various

Form 6198 AMT, Various

- No SI1ecific SChedule K-1 line reference for these amounts.

18.3

Schedule

E
&

PASSTHRO!-JGH

RECAP

CARRYOVEl1ti

TQ NEXT YEAR

RAFAEL E Entity No. Act No.

HEIDI S CRUZ
Schedule E Passive Activity Loss C/O SCh~~uleE L;~~~%

~
ST Capital PAL C/O AMT ST Capital PAL C/O LT Capital PAL C/O AMT LT Capital PAL C/O Section 1231 PAL se~~~nc/o C/O
72 _72

Ordinary PAL C/O

AMT ~~tn~:6

Schedule E At-Risk ~_over

AMT Schedule E At·Risk Carryover

I

ST Capital At·Risk Carryover

AMT ST Capital At-Risk Carryover

LT Capital Ic~~~~~r

AMT LTCapital At-Risk Carryover

4

3

3 315

2 .5_88

l

Totals

.........

.a.ais.

2 588

72

72

Entity No.

Act No.

se_~i~~i~~3 Carryover

AMT Section 1231 At-Risk Carryover

Form 4797 Ordinary At-Risk Carryover

AMT Form 4797 Ordinary At·Rlsk

c/o

Charitable Contributions At-Risk Carryover

AMT Charitable Contributions At·Risk

c/o

Section 179 Expense At-Risk

c/o

AMT Section 179 Expense At·Risk

c/o

Portfolio Income Deductions At·Risk

c/o

Keogh, SEP, IRA At·Risk

c/o

AMT Keogh, SEP, IRA At·Risk

c/o

Other At-Risk Carryovers

AMTOther At·Risk Carryovers

Totals

.........

028074

05·01·10

*

-

No Sl ecific Schedule K-1 line reference for these amounts.

18.4

Schedule

E
&

~A&

I .::--

~JG,", RECAP

ADDITIONAL

INFORMATION

AND PRIOR -,!,_EAI!

BASiS CARRYOVERS
~

RAFAEL E
Schedule K-1 Line Reference: (1065/1120S/1041)

HEIDI S
6b/5b/2b Qualified Dividends
2

ICRUZ

11/101*

131*1*

13112/14
Qualified Production Activities Income

13/121* Employer's W-2Wages

15/131*
Undistributed Capital Gains

15/13/13
Empowerment Zone Credit

15/13/13
Credit for Increasing Research Activities

15/131*

Entity No,
2

Act. Na_
2

1256 Dependent Contracts & Care Benefits Straddles

Sec,

15/131*

20/17/13

*1*1*
Royaltyl Depletion Exoenses

New Markets Credit for SS Recapture of Credit & Medicare Low-income Taxes IHousinc Credit

1.059

Totals ......... Component of:

2

Form 1040, Form 6781, Line 9b Line 1

Form 2441 Line 14

Form 8903, Line 7

Form 8903, Line 15

1.059 Form 1040, Form 8844, Line 70 Line 3

Form 6765, Line 37

Form 8874, Line 2

Form 8846, Line 5

Form 8611, Schedule E, Line 8 Page 1 or 2

Schedule K-1 Line Reference: (1065/1120S/1041)

*

*
AMT Schedule E Basis Carryover

*

*

*

*

*

*
AMT Sec. 1231 Basis Carryover

*

*

*

*

Entity No,

Act. No,

Schedule E ca~~~~er

ST ca~~~~er

AMT Basis Carryover

LT Basis Carryover

AMT E:r~~~~r

sec,

1231

ca~~~~er

4797-0rd_ Basis Carry_over

AMT
4797-0rd. Basis Carryover

Ir-

Other Basis

.-

AMT Other Basis Carryovers

Totals ......... Component of:

Basis Limitation Worksheet

Basis Limitation Worksheet

Basis Limitation Worksheet

Basis Limitation Worksheet

Basis Limitation Worksheet

Basis Limitation Worksheet

Basis Limitation Worksheet

Basis limitation Worksheet

Basis Limitation Worksheet

Basis Limitation Worksheet

Basis Limitation Worksheet

-SaslS
Limitation Worksheet

028076 05-01-10

* . No SI ,ecific Schedule K-1line reference for these amounts.

18.5

Schedule E
Name of Activity:

Publicly Traded Partnerships
ENTERPRISE PRODUCTS PARTNERS - ACTIVITY NO. 3

Activity net income Activity net loss Prior year unallowed losses Net income (loss) Total loss allowed from the PTP for 2010 Disallowed losses from this PTP

-2,036. -1,351. -3,387.

3,387.
Gain/Loss Prior Year Carryover Net Gain/Loss Unallowed Loss Allowed Loss

Form or Schedule

SCH E FORM 4797

-2,00l. -35.

1,314. 37.

-3,315. -72.

3,315. 72.

-2,036.

1,351.
Alternative

-3,387.
Minimum Tax

3,387.

Activity net income Activity net loss Prior year unallowed losses Net income (loss) Total loss allowed from the PTP for 2010 Disallowed losses from this PTP

-1,633. -1,027. -2,660.

2,660.

Alternative minimum tax adjustment Prior Year Carryover

Form or Schedule

Gain/Loss

Net Gain/Loss

Unallowed Loss

Allowed Loss

SCH E FORM 4797

-1,598. -35.

990. 37.

-2,588. -72.

2,588. 72.

-1,633.
010031 05-01-10

1,027.

-2,660.

2,660.

15211006

786859 CRUZ

2010.03060

19 CRUZ, RAFAEL

E

CRUZ

1

2010 DEPRECIATION AN

AMORTIZATION REPORT

CONDO
Asset No.

- 3333 ALLEN

PKWY UNIT 2606, HOU
Date Acquired Method Life
Line
No.

Unadjusted Cost Or Basis

Bus% Excl

Reduction In Basis

*

Basis For Depreciation

Accumulated Depreciation

Current Sec 179

Current Year Deduction

376,000.

376,000.

15,382.

13,673.

376,0 O.

15,382.

13,673.

028102 05·01·10

(0) . Asset disposed

* lTC, Section 179, Salvage, Bonus, Commercial

Revitalization

Deduction

19.1

AMORTIZATION

REPORT

- 1510 HARTFORD
Asset No.

RD, AUSTI
Method Life
Line No.

Date Acquired

Unadjusted Cost Or Basis

Bus% Excl

Reduction In Basis

.

Basis For Depreciation

Accumulated Depreciation

Current Sec 179

Current Year Deduction

300,000. 50,000

300,000. 5.0,0.00.

19,545.

10,909.

o.
19,545 10,909.

350,000 .

028102 05-01-10

(D) - Asset disposed

• lTC, Section 179, Salvage, Bonus, Commercial

Revitalization

Deduction

19.2

SCHEDULESE (Form 1040)
Department of the Treasury Internal Revenue Service

OMS No. 1545-0074

Self-Employment Tax
~ Attach to Form 1040 or Form 1040NR. ~ See Instructions for Schedule SE (Form 1040). income (as shown on Form 1040) Social security number of person with self-employment income

Attachmen~o.

2010 17

Name of person with self-employment

Before

you begin: To determine if you must file Schedule

SE, see the instructions

on page SE-1.

May I Use Short Schedule SE or Must I Use Long Schedule SE?
Note. Use this flowchart only if you must file Schedule SE. If unsure, see Who Must File Schedule SE, on page SE-1.

Did you receive wages or tips in 2010?

,..

No

Are you a minister, member of a religious order, or Christian Science practitioner who received IRS approval not to be taxed on earnings from these sources, but you owe self-employment tax on other earnings?

t

Yes_..

..

,

Yes

Was the total of your wages and tips subject to social security or railroad retirement (tier 1) tax plus your net earnings from self-employment more than $106,800? No Did you receive tips subject to social security or Medicare tax that you did not report to your employer? No ~ Did you report any wages on Form 8919, Uncollected Social Security and Medicare Tax on Wages?

~

+- No
Are you using one of the optional methods to figure your net earnings (see page SE-5)? No Did you receive church employee income (see page SE-1) reported on Form W-2 of $108.28 or more? No Yes

..

~

Yes

..

~

I

You may use Short Schedule SE below

I

You must use Long Schedule SE on page 2

1"

I

Section A-Short Schedule SE. Caution.

Read above to see if you can use Short Schedule Schedule K-1

SE.

1a Net farm profit or (loss) from Schedule F, line 36, and farm partnerships, (Form 1065), box 14, code A b If you received social security retirement or disability Program payments 2 included on Schedule Net profit or (loss) from Schedule C, line 31; Schedule

. benefits, enter the amount of Conservation Reserve . F, line 6b, or listed on Schedule K·1 (Form 1065), box 20, code Y of religious orders,

C-EZ, line 3; Schedule K-1 (Form 1065), box 14, code A

(other than farming); and Schedule K-1 (Form 1065·8), box 9, code J1. Ministers and members 3 4 Combine lines 1a, 1b, and 2. Subtract

see page SE·1 for types of income to report on this line. See page SE·3 for other income to report 29, and enter the result (see page SE-3) Multiply line 3 by 92.35% (.9235). If less than $400, you do not owe self-employment schedule 5 unless you have an amount on line 1b Note. If line 4 is less than $400 due to Conservation Self-employment • • 6 LHA $106,800 Form tax. If the amount on line 4 is:

S.T.MT....l.7. S.T.MT. 1.6.
1-'3~_---'=-.L-'-'O'=..L..:!6:....:6~6-=-.
1--=4~.J....-_-=-.t....:!c.=-.=...J~~::""::'"

from that total the amount on Form 1040, line 29, or Form 1040NR, line tax; do not file this ~ Reserve Program payments on line 1b, see page SE-3.

or less, multiply line 4 by 15.3% (.153). Enter the result here and on multiply line 4 by 2.9"/0 (.029). Then, add $13,243.20 1040NR, line 54 line 5 by 50% (.50). instructions. Schedule SE (Form 1040) 2010 of self-employment Act Notice, tax. Multiply to the result. .

1040, line 56, or Form 1040NR, line 54

More than $106,800, for one-half result For Paperwork

Enter the total here and on Form 1040, line 56, or Form Deduction

Reduction

see your tax return

024501 12-29-10

15211006

786859

CRUZ

2010.03060

20 CRUZ, RAFAEL

E

CRUZ

1

Form

1116
~

OMB No. 1545-0121

Foreign Tax Credit
(Individual, Estate, or Trust) Attach to Form 1040, 1040NR, 1041, or 990-T. Identifying number

2010
Attachmen~o.

Department of the Treasury Internal Revenue Service (99)

19

Name RAFAEL E & HEIDI Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. amounts in U.S. dollars except where specified in Part II below. a b
[XJ

as shown on page 1 of your tax return

Form 1116. Report all

D

Passive category income Generalcategory income

c d

D Section 901(j) income D Certain income re-sourced by treaty

e

D Lump-sum distributions

I Part
g

f Resident of (name of country) ~ UNITED STATES Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes tanore than one foreign country or U.S. possession, use a separate column and line for each country or possession.

I

I Taxable

Income or Loss From Sources

Outside the United States (for Category Foreic n Country A

Checked Above) C Total (Add cols. A 8, and C.l

or U.S. Possession B

Enter the name of the foreign country or U.S. possession ... .................. .. ................. ........ ~ 1a Gross income from sources within country shown above and of the type checked above:
_

IVARIOUS

HTKO

<v"
•••••••

167 970.
b Check if line 1a is compensation for personal services as an employee, your total compensation from all sources is $250,000 or more, and you used an alternative basis to determine its source (see instructions) Deductions and losses (Caution: See instructionS): 2 3 a b c d f:g:~~~~a~:~~~:)ly. r~'.to~~~~~.~Ta

-167 970.

1a

............ ~D
.. ~.O.

I··.·
'.

145 673. 111 466. 111 466. 168,000. 3,628,091. .046305 5,161.

Iii
>

~

Pro rata share of other deductions not definitely related: Certain itemized deductions or standard deduction ........ Other deductions (attach statement) ....... -_ .................• Add lines 3a and 3b .... - ........................................... Gross foreign source income ...................... -_ ...........

·····.·;J;«.C)

•• ..

>•..••••.. }

e Gross income from all sources ........ .. - ..................... f Divide line 3d by line 3e .............. - ................ .......... 9 Multiply line 3c by line 3f .......................................... Pro rata share of interest expense: 4 a Home mortgage interest (use worksheet on page 14 of the instructions) ...................................... ..... - ...... b Other interest expense ............................................. 5 Losses from foreign sources . . . .. .. . ....... . .... . ..... .... . .... . 6 Add lines 2 3g, 4a, 4b and 5 ............................. ......
_

•.>(i •••• ••,. ""

i'

3,742. 154 576.
............

f;
i;

,

-154 576.
SEE

H·~~t1tilll Foreign e ...
Credit is claimed for taxes (you must check one)
[XJPaid

7

Subtract line 6 from line 1a. Enter the result here and on line 14 page 2

. ................................................................

Taxes Paid or Accrued
Foreign taxes paid or accrued In foreign currency Taxes withheld at source on: (n) Other foreign taxes paid or accrued

~

6 7

STATEMENT

19

In U.S. dollars Taxes withheld at source on: (0)
Dividends

s
C

c (h) ::I

rn

Fl

Ar.r.nIRn

(j) ga!~J:~~ AIVARIOUS B

(k)

Dividends

(I)

~~~i~d

(m)

Interest

(PI

~~~~i:~d

(q)

Interest

(r) Other foreign taxes paid or aCCrUeD

(s)Total foreign taxes paid or accrued (add cols. (0) through (r))

13.

9 022.
~
8
Form

9 035.
J

8 Add lines A through C, column (s). Enter the total here and on line 9, page 2 LHA
011501 12-16-10

.....................

..................................................

9 035.

For Paperwork

Reduction

Act Notice, see instructions.

1116 (2010)

15211006

786859

CRUZ

2010.03060

21
CRUZ, RAFAEL E CRUZ

1

Page 2 9 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I 10 Carryback or carryover (attach detailed computation) 11 Add lines 9 and 10 12 Reduction in foreign taxes ..

-9,035.
13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit. 14 Enter the amount from line 7. This is your taxable income or (loss) from sources outside the United States (before adjustments) for the category of income checked above Part I 15 Adjustments to line 14
16 Combine the amounts on lines 14 and 15. This is your net foreign source taxable income. 14

15

(If the result is zero or less, you have no foreign tax credit for the category of income you checked above Part I. Skip lines 17 through 21. However, if you are filing more than one Form 1116, you must complete line 19.) .. 17 Individuals: Enter the amount from Form 1040, line 41, or Form 1040NR, line 39. Estates and trusts: Enter your taxable income without the deduction for your exemption Caution: If you figured your tax using the lower rates on qualified dividends or capital gains, see instructions. 18 Divide line 16 by line 17. If line 16 is more than line 17, enter "1" . 19 Individuals: Enter the amount from Form 1040, line 44. If you are a nonresident alien, enter the amount from Form 1040NR, line 42. Estates and trusts: Enter the amount from Form 1041, Schedule G, line la, or the total of Form 990-T, lines 36 and 37 Caution: If you are completing line 19 for separate categorye (lump-sum distributions),
see instructions.

..

20 Multiply line 19 by line 18 (maximum amount of credit) .. 21 Enter the smaller of line 13 or line 20. If this is the only Form 1116 you are filing, skip lines 22 through 26 and enter this amount on line 27. lete the line in Part IV 22 Credit for taxes on passive category income 23 Credit for taxes on general category income 24 Credit for taxes on certain income re-sourced by treaty
25 Credit for taxes on lump-sum distributions

..

. ..

26 Add lines 22 through 25 . 27 Enter the smaller of line 19 or line 26 28 Reduction of credit for international boycott operations . 29 Subtract line 28 from line 27. This is your foreign tax credit. Enter here and on Form 1040, line 47; line 40a
Form

4
1116
(2010)

011511 12-16-10

15211006

786859

CRUZ

2010.03060

22 CRUZ, RAFAEL

E

CRUZ

1

Form

1116
~

OMB No. 1545-0121

Foreign Tax Credit
(Individual, Estate, or Trust) Attach to Form 1040, 1040NR, 1041, or 990-T. Identifying number

2010
Attachmen~o.

Department of the Treasury Internal Revenue Service (99)

19

Name

as shown on page 1 of your tax return

Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. Check only one box on each Form 1116. Report all amounts in U.S. dollars except where specified in Part II below. a b

0

[XJ

Passive category income Generalcategory income

c d

0

0

Section 9010) income Certain income re-sourced by treaty

e

0

Lump-sum distributions

f Resident of (name of country) ~ UNITED STATES Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes tanore than one
foreign country

or U.S.

possession,

use

a separate

column and line for each coun

g

Enter the name of the foreign country

or U.S.

possession . . 1a Gross income from sources within country shown above and of the type checked above:

Check if line 1a is compensation for personal services as an employee, your total compensation from all sources is $250,000 or more, and you used an alternative basis to determine its source instructions) Deductions and losses (Caution: See instructione:
b

2 3

Expenses definitely related to the income on line la (attach statement) . . . Pro rata share of other deductions not definitely related:

a Certain itemized deductions or standard deduction b Other deductions (attach statement) c Add lines 3a and 3b d Gross foreign source income e Gross income from all sources f Divide line 3d by line 3e . 9 Multiply line 3c by line 3f 4 Pro rata share of interest expense: a Home mortgage interest (use worksheet on page 14 of the instructions) b Other interest expense 5 . . .

LHA

For Paperwork

Reduction

Act Notice,

see instructions.

Form

1116

(2010)

011501 12·16·10

15211006

786859

CRUZ

2010.03060

23 CRUZ, RAFAEL

E

CRUZ __ 1

2 9 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I 10 Carryback or carryover (attach detailed computation) 11 Add lines 9 and 10 12 Reduction in foreign taxes

HTKO
13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit 14 Enter the amount from line 7. This is your taxable income or (loss) from sources outside the

9,035.
9

United States (before adjustments) for the category of income checked above Part I 15 Adjustments to line 14 16 Combine the amounts on lines 14 and 15. This is your net foreign source taxable income. (If the result is zero or less, you have no foreign tax credit for the category of income you checked above Part I. Skip lines 17 through 21. However, if you are filing more than one Form 1116, you must complete line 19.) ._._._.. _ 17 Individuals: Enter the amount from Form 1040, line 41, or Form 1040NR, line 39. Estates and trusts: Enter your taxable income without the deduction for your

14

1

13 394.

exemption .. _ _. S..E.E S..'r~:r.E.:ME.N'r 21. Caution: If you figured your tax using the lower rates on qualified dividends or capital gains, see instructions. 18 Divide line 16 by line 17. If line 16 is more than line 17, enter'l' _ _ _._ _ __ . 19 Individuals: Enter the amount from Form 1040, line 44. If you are a nonresident alien, enter the amount from Form 1040NR, line 42. Estates and trusts: Enter the amount from Form 1041, Schedule G, line la, or the total of Form 990- T, lines 36 and 37 . Caution: If you are completing
line 19 for separate categorye (lump-sum distributions), see instructions.

.00

20 Multiply line 19 by line 18 (maximum amount of credit) 21

_

.__

_.. __

___

_._

.

22 Credit for taxes on passive category income 23 Credit for taxes on general category income 24 Credit for taxes on certain income re-sourced by treaty 25 Credit for taxes on lump-sum distributions 26 Add lines 22 through 25 _._ _._. 27 Enter the smaller of line 19 or line 26
28 Reduction of credit for international boycott operations .. _.__ ._ _ 29 Subtract line 28 from line 27. This is your foreign tax credit. Enter here and on Form 1040, line 47; 1041
Form

1116

(2010)

011511 12·16·10

15211006

786859

CRUZ

2010.03060

24 CRUZ, RAFAEL

E

CRUZ

1

Form

3800

General Business Credit
~ ~ See separate Attach instructions. to your tax return.

Important: You may not be required to complete and file a separate credit form (shown in parentheses credit. For details. see the instructions. 1a b c d e f h Investment credit (Form 3468. Part" only) (attach Form 3468)

below) to claim the . . . . . . . . . 1a 1b 1c 1d 1e 1f 19 1h 1i 1j .......,.1k"-t f-1,_,_1-+1---'-1,_,_m~-------1---'1"'n-+1---'1""0-+1---'1~p-l1---'1c=L.Q-t--------1---'1'-'..r-l_ _ _ _ _ _ _ __ _ _ _ _ _ _

Reserved for future use Credit for increasing Low-income entity: Renewable electricity research activities ) production credit (Form 8835) housing credit (Form 8586. Part I only) (enter EIN if claiming this credit from a pass-through

Disabled access credit (Form 8826) (do not enter more than $5,000) credit

9 Indian employment

Orphan drug credit (Form 8820) New markets credit (Form 8874) (enter EIN if claiming this credit from a pass-through entity: ) child care facilities and services (Form 8882) (enter EIN if claiming entity: Credit for small employer pension plan startup costs (Form 8881) (do not enter more than $500)

k

Credit for employer-provided this credit from a pass-through

2 3 - 0 8 91 0 5 0 )

=1-=5:._::1=-=
_

Biodiesel and renewable diesel fuels credit (attach Form 8864) m Low sulfur diesel fuel production n o P q r s u v w x y z Distilled spirits credit (Form 8906) Nonconventional Energy efficient Alternative entity: Alternative Employer housing credit Agricultural chemicals .. _............. source fuel credit (Form 8907) home credit credit (Form 8909) ) fuel vehicle refueling property credit (Form 8911) .. credit (Form 8896)

Energy efficient appliance

motor vehicle credit (Form 8910) (enter EIN if claiming this credit from a pass-through 1---'1'-=s-lf-1,_,t-+1---'1"'u-+1---'1'-"v-tf---'-1.!.'w-+1---'1~x-t1---'1CL_y-t------1---'1"'z-+1-'-'1a::.:a=+ (Schedule K-1 (Form 1065-B)) ...1.:.:b,.,b=+ r--=2=--t . 1---'3,._-t--------4 1-'5"---t------for the schedule to attach .

Mine rescue team training credit Credit for employer differential Carbon dioxide sequestration

security credit (Form 8931) (do not enter more than $2 million) wage payments................................................................................................... credit (Form 8933)

Qualified plug-in electric drive motor vehicle credit (Form 8936) Qualified plug-in electric vehicle credit (Form 8834, Part I only) credit (Form 5884-B) 1bb

aa New hire retention 2 3 4

bb General credits from an electing large partnership Add lines 1a through

=1-=5:._::1~.

Passive activity credits included on line 2 (see instructions) Subtract line 3 from line 2

151.
_

5

Passive activity credits allowed for 2010 (see instructions) Carryforward Carryback of general business credit to 2010. See instructions

6

6

7
8 LHA

of general business credit from 2011 (see instructions)

f-7~+-

_

Add lines 4 through .(see instructions) For Paperwork

7. Subtract from that sum any eligible small business credits and enter the result

.s.TMT ...22.
Reduction Act Notice, see separate instructions.

8

o.
Form 3800 (2010)

SBC
014401 02-02-11

151. 25 CRUZ,

15211006

786859

CRUZ

2010.03060

RAFAEL

E

CRUZ

1

Form 3800 (2010)

Page 2

Lpttrtj'lI
9

Allowable Credit
Enter the amount from Form 1040, line 44 or Form 1040NR, line 42 Enter the amount from Form 1120, Schedule J, line 2; or the . line of your return . line of your return .

Regular tax before credits: • Individuals. • Corporations. applicable

603

• Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a and 1b, or the amount from the applicable 10 Alternative minimum tax: Enter the amount from Form 6251, line 35 Enter the amount from Form 4626, line 14 I (Form 1041), line 56 . . . . . }

• Individuals. • Corporations.

• Estates and trusts. Enter the amount from Schedule 11 Add lines 9 and 10

12a Foreign tax credit b Personal credits from Form 1040 or Form 1040NR (see instructions) c Add lines 12a and 12b

14 15 16

Net regular

tax. Subtract

line 12c from line 9. If zero or less, enter -0-

.

Enter 25% (.25) of the excess, if any, of line 14 over $25,000 (see instructions) Tentative minimum tax. If line 8 is zero and line 24 would be zero, skip lines 16 see instructions . . . amount . ' if there has been an ownership change, acquisition, .

through 25 and go to line 26. Otherwise, 17 Enter the greater of line 15 or line 16

18a Subtract

line 17 from line 13. If zero or less, enter -0· electing to accelerate the research credit, enter the bonus depreciation to the research credit. (see instructions) of line 8 or line 18c See the line 19a instructions

b For a corporation attributable

c Add lines 18a and 18b 19a Enter the smaller C corporations: or reorganization. b Enter the smaller of line 8 or line 18a. skip line 19c c Subtract line 19b from line 19a. This is the refundable this amount on line amount for a corporation of Form 1 electing to accelerate If you made an entry on line 18b, go to line 19c; otherwise,

.

Form 3800 (2010)

014402 02-02-11

15211006

786859 CRUZ

2010.03060

26 CRUZ, RAFAEL

E

CRUZ

1

Form 3800 (2010)

Page 3

rpartlll
20 21

Allowable Credit (Continued)

Note. If you are not filing_ Form 8844, skip lines 20 through 24 and enter ·0- on line 25_ Multiply line 16 by 75% Enter the greater of line 15 or line 20 Subtract Subtract line 21 from line 13. If zero or less, enter -0· line 19b from line 22. If zero or less, enter -0· any portion of the credit that is an eligible 24 employment credit allowed. Enter the smaller of line 23 . line 15 from line 13. If zero or less, enter -0· line 27 from line 26. If zero or less, enter -0· credit from Form 3468, Part III, line 20 (attach Form 3468) credit from Form 5884, line 10 or . 29b 29c housing credit from Form 8586, Part II, line 18 !-'29=d"+ part of the amount of the renewable electricity, refined coal, 1-'29=e~ 1-=291=--t-~29=m~ entities, other than farmers' cooperatives, _ do not ~29=h~
---j

. . . .

20 21

22 23
24 25

22
23

Enter the amount from Form 8844, line 10 or line 12, excluding small business credit Empowerment or line 24 Subtract Subtract zone and renewal community

25

26
27 28

. . . !-'29=a"+ ---l

26
27 28

455 439. 455 439.

O.

If you skipped lines 16 through 25, enter -0·. Otherwise, add lines 19b and 25

O.

29a Enter the investment line 12

b Enter the work opportunity

c Enter the alcohol and cellulosic biofuel fuels credit from Form 6478, line 15 or line 17 d Enter the low-income or line 20 e Enter the applicable and Indian coal production credit from Form 8835, Part II, line 36 or line 38

---l

f Enter the credit for employer social security and Medicare taxes paid on certain employee tips from Form 8846, line 12
--1

9 Enter the qualified railroad track maintenance
8900, line 12

credit from Form

~1

h Enter the credit for small employer health insurance premiums from Form 8941, line 21 or line 23 (tax-exempt complete 30 31 32 pass-through entity: this line· see instructions) (enter EIN if claiming this credit from a

~1
,

Add lines 29a through 29h and increase that sum by any eligible small business credits and enter the result (see instructions) Enter the smaller Credit allowed of line 28 or line 30 year. Add lines 27 and 31. as } 32 : ~::~:::~:~~::' F~r:~~~~~~~~e~~::eG~~in~·2·b····::::::::.::::::::::::::::::::::::.:::::::::::::::::::::::::: line of your return: for the current . .

30
31

1 210. 1 210.

Report the amount from line 32 (if smaller than the sum of lines 8, 24, and 30, see instructions) indicated below or on the applicable • Individuals. Form 1040, line 53 or Form 1040NR, line 50

1 210.
Form 3800 (2010)

014403 02-02-11

15211006

786859

CRUZ

2010.03060

27 CRUZ, RAFAEL E

CRUZ

1

Form

4797
E & HEIDI

Sales of Business Property
(Also Involuntary Conversions and Recapture Under Sections 179 and 280F{b){2» See Amounts instructions.

Department of the Treasury Internal Revenue Service Name(s) shown on return

RAFAEL

1 Enter the gross proceeds from sales or exchanges <>t"tonnon,tI that

reported to you for 2010 on Form(s) 1099·8 or 1099·S

(a) Description
of property

(b)

Date acquired (mo., day, yr.)

(e) Date

sold (mo., day, yr.)

(d)

Gross sales price

(e)

2

Depreciation allowed or allowable since acquisition

Cost or other basis. plus improvements and expense of sale

(f)

(0) Gain or (loss)
Subtract (I) from the sum of (d) and (e)

ENTERPRISE PA IPARTNERS
3 4 5

PRODUCTS

o.
42 ..................................................................................................................... sales from Form 6252, line 26 or 37 .................................................................. from Form 8824 ..................................................................... .................................................................................... line as follows: .............................. 3 4 5

Gain, if any, from Form 4684,line Section 1231 gain from installment

Section 1231 gain or (loss) from like-kind exchanges

6
7

Gain, if any, from line 32, from other than casualty or theft

6
7

Combine lines 2 through 6. Enter the gain or (loss) here and on the appropriate

Partnerships (except electing large partnerships) and S corporations. Report the gain or (loss) following the instructions for Form 1065, Schedule K, line 10, or Form 1120S, Schedule K, line 9. Skip lines 8, 9, 11, and 12 below. Individuals, partners, S corporation shareholders, and all others. If line 7 is zero or a loss, enter the amount from line 7 on line 11 below and skip lines 8 and 9. If line 7 is a gain and you did not have any prior year section 1231 losses, or they were recaptured in an earlier year, enter the gain from line 7 as a lonq-term capital gain on the Schedule 0 filed with your return and skip lines 8, 9,11, and 12 below.

!-

8
9

Nonrecaptured Subtract

net section 1231 losses from prior years (see instructions)

............................................................

8

line 8 from line 7. If zero or less, enter ·0·. If line 9 is zero, enter the gain from line 7 on line 12 below. If

line 9 is more than zero, enter the amount from line 8 on line 12 below and enter the gain from line 9 as a lonq-term capital gain on the Schedule 0 filed with your return (see instructions)

..................................................................

9

Ordinary Gains and Losses
10

(see instructions)

11 12 13 14 15 16 17 18

Loss, if any, from line 7 Gain, if any, from line 7 or amount from line 8, if applicable Gain, if any, from line 31 Net gain or (loss) from Form 4684, lines 34 and 41a Ordinary gain from installment Combine lines 10 through For all except individual 16 line of your return and skip lines returns, complete lines a and b below: sales from Form 6252, line 25 or 36 from Form 8824 Ordinary gain or (loss) from like·kind exchanges

. . . . . . .

returns, enter the amount from line 17 on the appropriate

a and b below. For individual a

If the loss on line 11 includes a loss from Form 4684, line 38, column (b)(ii), enter that part of the loss here. Enter the part of the loss from Income-producinq property on Schedule A (Form 1040), line 28, and the part of the loss from property used as an employee on Schedule A (Form 1040), line 23. Identify as from "Form 4797, line 18a." the loss, if any, on line 18a. Enter here and on instructions. Form 4797 (2010)

b LHA

Redetermine

the gain or (loss) on line 17 excluding Reduction Act Notice,

For Paperwork

see separate

018011 12-21-10

15211006

786859 CRUZ

2010.03060

~RTJ7..

R1I.F1I.F.T. F.

1

Forrn4797

2

rPart 1111
19 A

Gain From Disposition

of Property

Under Sections

1245, 1250, 1252, 1254, and 1255

(see instructions) (c) Date sold (mo., day, yr.)

(a) Description

of section 1245, 1250, 1252, 1254, or 1255 property:

(b) Date acquired (mo., day, yr.)

B
C 0 These columns 20 21 22 23 24 25 relate to the properties 190. on lines 19A through

~
20 21 22 23 24 25a 25b

Property

A

Property

B

PropertyC

Property

0

Gross sales price (Note: See line 1 before completing.) Cost or other basis plus expense of sale ............ Depreciation Adjusted If section (or depletion) allowed or allowable ... basis. Subtract line 22 from line 21 ._-.-. line 23 from line 20 ...............

Total (lain. Subtract a Depreciation

1245 property: allowed or allowable from line 22 of line 24 or 25a .....................
...

b Enter the smaller 26

If section 1250 property: If straight line depreciation was used, enter ·0- on line 26g, except for a corporation subject to section 291. a Additional depreciation after 1975 (see instructions)
...

26a 26b

b Applicable percentage multiplied by the smaller of line 24 or line 26a (see instructions) ............... c Subtract line 26a from line 24. If residential rental property or line 24 is not more than line 26a, skip lines 26d and 26e ............... - •...........••....•.......... d Additional depreciation after 1969 and before 1976 ...... e Enter the smaller of line 26c or 26d
........... ......

26c
26d 26e 26f 26Q

f Section 291 amount (corporations

only)

............

Q Add lines 26b 26e and 26f .............................. 27 If section 1252 property: Skip this section if you did not dispose of farmland or if this form is being completed for a partnership (other than an electing large partnership). a Soil, water, and land clearing expenses ..... .. - ...... b Line 27a multiplied by applicable percentage ...... c Enter the smaller 28 of line 24 or 27b ...................
-- ..

27a 27b 27c

If section 1254 property: a Intangible drilling and development costs, expenditures for development of mines and other natural deposlts, mining exploration costs, and depletion (see instructions)

28a 28b 29a 29b D through line 2gb before going to line 30.

b Enter the smaller of line 24 or 28a ..................... If section 1255 property: 29 a Applicable percentage of payments excluded from income under section 126 (see instructions) b Enter the smaller of line 24 or 29a (see instructions)

Summary
30 31 32

of Part III Gains.

Complete

property columns A through

Total gains for all properties. Add property columns Subtract

Add property columns A through

D, line 24

A through

D, lines 25b, 26g, 27c, 28b, and 2gb. Enter here and on line 13

line 31 from line 30. Enter the portion from casualty or theft on Form 4684, line 36. Enter the portion

Recapture

Amounts

Under Sections

179 and 280F(b)(2) When Business

Use Drops to 50% or Less
(a) Section 179 (b) Section 280F(b)(2)

(see instructions)

33 34 35
018012

Section 179 expense deduction Recomputed Recapture
12-21-10

or depreciation

allowable in prior years .................................
'"

depreciation

(see instructions)

..................................................................

amount.

Subtract

line 34 from line 33. See the instructions

for where to report

... - ..

33 34 35
Form

4797

(2010)
1

15211006

786859

CRUZ

?o10_0~nhn

C"RTT'Z

29

Fonn

6251

OMS No. 1545-0074

Alternative Minimum Tax - Individuals
Attach to Form 1040 or Form 1040NR.

Department of the Treasury Internal Revenue Service (99)

2010
Your social security number

Name(s) shown on Form 1040 or Form 1040NR

1 If filing Schedule 2 4 6 8

A (Form 1040), enter the amount from Form 1040, line 41 and go to line 2. Otherwise, smaller or

enter the . .

amount from Form 1040, line 38 and go to line 6. (If less than zero, enter as a negative amount.)
Medical and dental. Enter the of Schedule A (Form 1040), line 4, 2.5% (.025) of Form 1040, line 38. If zero or less, enter -0- ..........•....

3 Taxes from Schedule A (Form 1040), lines 5, 6, and 8 Enter the home mortgage interest adjustment, deductions if any, from line 6 of the worksheet on page 2 of the instructions 5 Miscellaneous from Schedule A (Form 1040), line 27

. . . . . . . . . . . . . . . . . . . . . . .

If filing Schedule L (Form 1040A or 1040), enter as a negative amount the sum of lines 6 and 17 from that schedule Investment interest expense (difference between regular tax and AMl) (difference between regular tax and AMl) from Form 1040, line 21. Enter as a positive amount loss deduction

7 Tax refund from Form 1040, line 10 or line 21 9 Depletion 11 Alternative

10 Net operating

tax net operating loss deduction private activity bonds exempt from the regular tax under section 1202) stock options (excess of AMT income over regular tax income) K-1 (Form 1041), box 12, code A) K-1 (Form 1065-8), box 6) between regular tax and AMl) (amount from Schedule

12 Interest from specified 14 Exercise of incentive

13 Qualified small business stock (7% of gain excluded 15 Estates and trusts (amount from Schedule 16 Electing large partnerships 17 Disposition 18 Depreciation 20 22 23 24 25 26 of property

(difference between AMT and regular tax gain or loss)

on assets placed in service after 1986 (difference (difference

S.'r.l'1'r

~.J.

19 Passive activities Loss limitations Long-term Research Intangible 21 Circulation

(difference between AMT and regular tax income or loss) between AMT and regular tax income or loss)

costs (difference between regular tax and AMl) contracts (difference between AMT and regular tax income) between regular tax and AMl) costs (difference between regular tax and AMl)

Mining costs (difference

and experimental

Income from certain installment sales before January 1, 1987 drilling costs preference including income-based taxable income. related adjustments and line minimum Combine lines 1 through 27. (If married filing separately

27 Other adjustments, 28 Alternative

29

Exemption. (If you were under age 24 at the end of 2010, see instructions.) IF your filing status is... AND line 28 is not over THEN enter on line 29 Single or head of household Married filing jointly or qualifying widow(er)......... Married filing separately. $112,500 150,000. 75,000· $47,450 72,450 36,225 } .

30

If line 28 is over the amount shown above for your filing status, see instructions. Subtract line 29 from line 28. If more than zero, go to line 31. If zero or less, enter -0- here and on lines 33 and 35 and skip the rest of Part II . for the amount to enter.

31 • If you are filing Form 2555 or 2555-EZ, see page 9 of the instructions

• If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends on Form 1040, line 9b; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040) (as refigured for the AMT, if necessary), complete Part ilIon page 2 and enter the amount from line 54 here . • All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately), multiply line 30 by 26% (.26). Otherwise, multiply line 30 by 28% (.28) and subtract $3,500 ($1,750 if married filing 32 Alternative 33 Tentative minimum minimum tax foreign tax credit (see instructions) tax. Subtract line 32 from line 31

..........................................................................................

34 Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040, line 47). If you used Sch J to figure your tax, the amount from line 44 of Form 1040 must be refigured without using Sch J 33. If LHA
019481 12-21-10

line 45 see your tax return instructions. Form 6251 (2010)

For Paperwork

Reduction

Act Notice,

15211006

786859

CRUZ

2010.03060

29.1 CRUZ, RAFAEL

E

CRtJ7.

1

2
36 37 Enter the amount from Form 6251, line 30. If you are filing Form 2555 or 2555·EZ, enter the amount from line 3 of the worksheet in the instructions Enter the amount from line 6 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from in the instructions for Schedule D for . If you are filing Form 2555 or 2555·EZ, 1---!38=-+-----------1 for the regular tax or the add lines 37 and 38, and enter If you are filing Form 2555 . . . $3,500 ($1,750 if married filing separately) from ~ widow(er), or Dividends and Capital Gain for Schedule D } . 43 line 13 of the Schedule D Tax Worksheet the instructions). 38 .

(Form 1040), whichever applies (as refigured for the AMT, if necessary) (see If you are filing Form 2555 or 2555·EZ, see instructions

the amount to enter Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT, if necessary) (see instructions). see instructions 39 for the amount to enter

5

113.

If you did not complete a Schedule D Tax Worksheet AMT, enter the amount from line 37. Otherwise, the smaller Worksheet

of that result or the amount from line 10 of the Schedule D Tax (as refigured for the AMT, if necessary). for the amount to enter of line 36 or line 39

or 2555·EZ, see instructions 40 42 Enter the smaller 41 Subtract Otherwise, the result 43 Enter: line 40 from line 36

If line 41 is $175,000 or less ($87,500 or less if married filing separately), multiply line 41 by 26% (.26). multiply line 41 by 28% (.28) and subtract

• $68,000 if married filing jointly or qualifying • $34,000 if single or married filing separately, • $45,550 if head of household. 44 Enter the amount from line 7 of the Qualified Tax Worksheet in the instructions line 14 of the Schedule (Form 1040), whichever complete 45 46 47 48 Subtract D Tax Worksheet

for Form 1040, line 44, or the amount from in the instructions

applies (as figured for the regular tax). If you did not for the regular tax, enter ·0· f-4.:.:5'-+ f-46:.=...-I-

either worksheet

line 44 from line 43. If zero or less, enter ·0· of line 36 or line 37 of line 45 or line 46

---'O~.
....:5=-.L..:1=-=1:..:3~.

Enter the smaller Enter the smaller Subtract

line 47 from line 46

48

5

113.
~

49

Multiply line 48 by 15% (.15) If line 38 is zero or blank, skip lines 50 and 51 and go to line 52. Otherwise, go to line 50. 50

50

Subtract

line 46 from line 40

51

Multiply line 50 by 25% (.25)

~ . multiply line 36 by 26% (.26). . 53

52 Add lines 42, 49, and 51 53 If line 36 is $175,000 the result 54 Enter the smaller this of line 52 or line 53 here and on line 31. If you are filing Form 2555 or 2555·EZ, do not enter or less ($87,500 or less if married filing separately),

537

019591 12-21-10

15211006

786859

CRIJ'1.

?()1()_()~n~n

29.2
I'"'RTT'7.
("lHT'7

1

ALTERNATIVE Name(s)

MINIMUM

TAX RECONCILIATION

REPORT Social Security Number

Adjustment Income Form 6251 , Line 17 Form 6251, Line 18 Form 6251, Line 19 Form 6251, Line 20

-78. -78.

-346 -346. -346.

019911 11-09-10

ALTERNATIVE

MINIMUM

AX DEPRECIATION

REPORT

Asset
No.

Description

Date Acquired

AMT Method

AMT Life

AMT Cost Or Basis

AMT Accumulated

Regular Depreciation

AMT Depreciation

AMT Adjustment

376,000. 376,000.

15,382. 15,382

13,673. 13,673.

13,673. 13,673

0.

o

300,000 300,000 676,000.

19,545 19,545. 34,927.

10,909. 10,909. 24,582.

10,909. 10,909. 24,582.

0. O. O.

028104 05-01-10

29.4

Form

1116
~

ALTERNATIVE

Foreign Tax Credit

MINIMUM

TAX

OMS No. 1545-0121

Department of the Treasury Internal Revenue Service

(Individual, Estate, or Trust) Attach to Form 1040, 1040NR, 1041, or 99O-T. Identifying number

2010

Attachment Sequence No.

19

Name

as shown on page 1 of your tax return

Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. Check only one box on each Form 1116. Report all amounts in U.S. dollars except where specified in Part" below. a b

D

[X]

Passive category income Generalcategory income

c d

D

D

Section 9010) income Certain income re-sourced by treaty

e

D

Lump-sum distributions

f Resident of {name of country) ~ UNITED STATES Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes tanore than one
foreign country or U.S. possession, use

a separate

column and line for each country or possession.

bRart'.j
g

Taxable Income or Loss From Sources

Outside the United States (for Category Forelc n Country A
B

Checked

Above) C Total (Add cols. A, B and C.)

or U.S. Possession

Enter the name of the foreign country or U.S. possession ........... - .......... ..........................• . ~ 1a Gross income from sources within country shown above and of the type checked above:

VARIOUS

HTKO

167 976.
b Check if line 1a is compensation for personal services as an employee, your total compensation from all sources is $250,000 or more, and you used an alternative basis to determine its source (see instructions) ... Deductions and losses (Caution: See instructione: 2 3 a b c d

-167,976.

1a

........ ~D

1····.)< 145,673.

."

<
.'.?:'

Expenses definitely related to the income on line 1a (attach statement) ................................................... Pro rata share of other deductions not definitely related: Certain itemized deductions or standard deduction ........ Other deductions (attach statement) ....... ................... Add lines 3a and 3b .......... ... .......... . ................... Gross foreign source income ............ ............. . ........
_,

. •..

........

e Gross income from all sources ........ .' .. ....... ...... f Divide line 3d by line 3e ............... ........ ... . ... g Multiply line 3c by line 3f .......... ........... .... ............ Pro rata share of interest expense: 4 a Home mortgage interest (use worksheet on page 14
, '" " '

,'

168 000. 3 621 809. .046386

.· .i·':
3 749. 149,422.
..........
,

:

\

• ••.•••.• . ;;{,;;.:<
..

of the instructions) ............... . ............ .. ........... b Other interest expense .................... ....... .. ....... ... 5 Losses from foreign sources ...........•...............•.... 6 Add lines 2, 3g, 4a, 4b and 5 .................. ............... .
'.,
,., , " ' , , ,

,

,

-149 422.
.....................
,

.....
. ..............

F l!jir!~~;'r;1oreign
Credit is claimed for taxes (you must check one)

7

Subtract line 6 from line 1a. Enter the result here and on line 14. page 2

..........

...... ...........

Taxes Paid or Accrued
Foreign taxes paid or accrued In foreign currency Taxes withheld at source on: (n) Other foreign
taxss n~ir1nr
Interest

~

6 7

In U.S. dollars Taxes withheld at source on:
(0) Dividends

~

§ (h) [X] Paid ,C;:liln ...
(j) ga~~~~~ AIVARIOUS
B

(k)

Dividends

(I)

~~;~«i~d

(m)

accrued

(P)

~~;~«i~d

( q)

Interest

(r) Other foreign taxes oaid or accrued

(s) Total foreign taxes paid or accrued i add cols, (0) through (r))

13.

9,022.
~
8
Form

9 035. 9 035.

C 8 Add lines A through C, column (s). Enter the total here and on line 9, page 2 LHA For Paperwork Reduction Act Notice, see instructions.

.......................................................................

1116 (2010)

011501 12-16-10

15211006

786859

CRUZ

2010.03060

30 CRUZ. RAFAEL

E

CRTJ7.

1

ALTERNATIVE
9 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I .. 10 Carryback or carryover (attach detailed computation) 11 Add lines 9 and 10 12 Reduction in foreign taxes .

MINIMUM

TAX

Page 2

HTKO
13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit
14 Enter the amount from line 7. This is your taxable income or (loss) from sources outside the

-9,035.

United States (before adjustments) for the category of income checked above Part I 15 Adjustments to line 14 .. . 16 Combine the amounts on lines 14 and 15. This is your net foreign source taxable income. (If the result is zero or less, you have no foreign tax credit for the category of income you checked above Part I. Skip lines 17 through 21. However, if you are filing more than one Form 1116, you must complete line 19.) . . 17 Individuals: Enter the amount from Form 1040,Iine 41, or Form 1040NR, line 39. Estates and trusts: Enter your taxable income without the deduction for your

.

exemption . Caution: If you figured your tax using the lower rates on qualified dividends or capital gains, see instructions. 18 Divide line 16 by line 17. If line 16 is more than line 17, enter '1' . . 19 Individuals: Enter the amount from Form 1040, line 44. If you are a nonresident alien, enter the amount from Form 1040NR, line 42. Estates and trusts: Enter the amount from Form 1041, Schedule G,line 1a, or the total of Form 990-T, lines 36 and 37 . Caution: If you are completing line 19 for separate categorye (lump-sum distributions),
see instructions.

20 Multiply line 19 by line 18 (maximum amount of credit) .. . 21 Enter the smaller of line 13 or line 20. If this is the only Form 1116 you are filing, skip lines 22 through 26 and enter this amount on line 27. the line in Part IV . 22 Credit for taxes on passive category income 23 Credit for taxes on general category income 24 Credit for taxes on certain income re-sourced by treaty 25 Credit for taxes on lump-sum distributions 26 Add lines 22 through 25 . 27 Enter the smaller of line 19 or line 26 28 Reduction of credit for international boycott operations . 29 Subtract line 28 from line 27. This is your foreign tax credit. Enter here and on Form 1040, line 47;
Form

. . .

1116

(2010)

011511 12-16-10

15211006

786859

CRUZ

2010.03060

31 CRUZ, RAFAEL

E

CRUZ

1

Form

1116
~

ALTERNATIVE

Foreign Tax Credit

MINIMUM

TAX

OMS No. 1545-0121

Department of the Treasury Internal Revenue Service (99)

(Individual, Estate, or Trust) Attach to Form 1040, 1040NR, 1041, or 99O-T. Identifying number

2010
Attachmen~o.

19

Name

as shown on page 1 of your tax return

RAFAEL
a b

E & HEIDI S
c d

Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. amounts in U.S. dollars except where specified in Part" below.

D

[X]

Passive category income Generalcategory income

D D

Section 901(j) income Certain income re-sourced by treaty

e

D

Lump-sum distributions

f Resident of (name of country) ~ UNITED STATES Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes tanore than one foreign country or U.S. possession, use a separate column and line for each country or possession.

It>~ttl I
g

Taxable Income or Loss From Sources

Outside the United States (for Category Foreiq n Country A

Checked

Above) C Total (Add cols. A, B, and C.)

or U.S. Possession B

Enter the name of the foreign country or U.S. possession ...................... ~ ....... . ................... 1a Gross income from sources within country shown above and of the type checked above:

~TKO

it" ......
167,976.
1a

167 976.

b Check if line 1a is compensation for personal services as an employee, your total compensation from a" sources is $250,000 or more, and you used an alternative basis to determine its source (see instructions) Deductions and losses (Caution: See instructione:

1,,\<·><
1f;<)
i.·i".i.·/L<:· >;,i" ...........
.....

/;ij~}I'
''''>
'.<
-,

........ ~D

..·.··.·.i • ..•
.c-,

'.

>

Expenses definitely related to the income on line 1a (attach statement) .......................................... ....... 3 Pro rata share of other deductions not definitely related: a Certain itemized deductions or standard deduction ......... b Other deductions (attach statement) ......... - ........... ..... c Add lines 3a and 3b ........... _- - . . . . . ... . .. .. . . . . .. . .. ... ...... d Gross foreign source income ................................. e Gross income from a" sources ........................... f Divide line 3d by line 3e ................. . . . . . . . . .. . ... .......... g Multiply line 3c by line 3f .................................... ..... Pro rata share of interest expense: 4 a Home mortgage interest (use worksheet on page 14 2

·.·}>i'·

..

.e;

>i

p.

I, . r",
I',
I,

1~;\i)t'(J;

><

.'<-><·s" .••••

("ea:lt'''fll
_j_dh,,.,·,,~;::~:)i-,

of the instructions) .................. . ... . . . .. . . . . .... . .. .......... b Other interest expense ............................... ............ . 5 Losses from foreign sources . . . ...... . .... . .. . ........ . . ..... . . . 6 Add lines 2, 3g, 4a 4b, and 5 .................................... 149 422. 7 Subtract line 6 from line ta, Enter the result here and on line 14 page 2 ............ ..................

. ...............

. ............................

Foreign Taxes Paid or Accrued
Foreign taxes paid or accrued In foreign currency Taxes withheld at source on:
A<=IJRri

~

7

149 422. 18 554.

~ c:
,9.,
A B C

Credit is claimed for taxes (you must check one) (h)
Ii\

In U.S. dollars (n) Other foreign taxes oaid or accrued Taxes withheld at source on: (0)
Dividends

;:,

n

[X]paid

(j) ga~~~~

(k)

Dividends

(I)

~ci'~~~i:d

(m)

Interest

(p)

~ci'~~~i:d

(q)

Interest

(r) Other foreign taxes paid or accrued

(s) Total foreign taxes paid or accrued '(add cols. (0) through (r))

8 Add lines A through C, column (s), Enter the total here and on line 9, pa.lle 2 LHA For Paperwork Reduction Act Notice, see instructions.
011501 12-16-10

.............................

..................

......................

~

8
Form

1116 (2010)

15211006

786859 CRUZ

2010.03060

32 CRUZ, RAFAEL

E

CRUZ

1

9 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I 10 Carryback or carryover (attach detailed computation) 11 Add lines 9 and 10 12 Reduction in foreign taxes . .

13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit. 14 Enter the amount from line 7. This is your taxable income or (loss) from sources outside the

United States (before adjustments) for the category of income checked above Part I ...
15 Adjustments to line 14 . 16 Combine the amounts on lines 14 and 15. This is your net foreign source taxable income. (If the result is zero or less, you have no foreign tax credit for the category of income

you checked above Part I. Skip lines 17 through 21. However, if you are filing more than one Form 1116, you must complete line 19.) 17 Individuals: Enter the amount from Form 1040, line 41, or Form 1040NR, line 39. Estates and trusts: Enter your taxable income without the deduction for your exemption . S.E.E S.'rb. 'rE.:W:E.N'r .24. Caution: If you figured your tax using the lower rates on qualified dividends or capital gains. see instructions.
18 Divide line 16 by line 17. If line 16 is more than line 17, enter "1" . 19 Individuals: Enter the amount from Form 1040, line 44. If you are a nonresident alien, enter the amount from Form 1040NR, line 42. Estates and trusts: Enter the amount from Form 1041, Schedule G, line la, or the total of Form 990-T,

.

~~~~
Caution: If you are completing
line 19 for separate categorye (lump-sum distributions).

.

see instructions. .

20 Multiply line 19 by line 18 (maximum amount of credit) 21 Enter the smaller of line 13 or line 20. If this is the only Form 1116 you are filing, skip lines 22 through 26 and enter this amount on line 27. the line in Part IV 22 Credit for taxes on passive category income
23 Credit for taxes on general category income

24 Credit for taxes on certain income re-sourced by treaty
25 Credit fortaxes on lump-sum distributions

. .

26 Add lines 22 through 25 . 27 Enter the smaller of line 19 or line 26 28 Reduction of credit for international boycott operations . 29 Subtract line 28 from line 27. This is your foreign tax credit. Enter here and on Form 1040, line 47;
Form

1116

(2010)

011511 12-16·10

15211006

786859

CRUZ

2010.03060

33 CRUZ. RAFAEL

E

CRtJ7.

1

SCHEDULE H (Form 1040)
Oepartment of the Internal Revenue

rsousehold Employment Taxes
(For Social Security, Medicare, Withheld Income, and Federal Unemployment ~ Attach to Form 1040, 1040NR, 1040-55, See separate instructions. or 1041. (FUTA) Taxes)

Name of employer Employer identification number

HEIDI S
A Did you pay anyone household employee cash wages of $1,700 or more in 2010? (If any household under age 21, your parent, or anyone under age 18, see the line A instructions

26-366612
employee was your spouse, your child on page H·4 before you answer this question.)

o
B

[XJ

Yes. No.

Skip lines Band C and go to line 1. Go to line B. employee?

Did you withhold federal income tax during 2010 for any household

o
C

o

Yes. No.

Skip line C and go to line 5. Go to line C. of 2009 or 2010 to all household employees?

Did you pay total cash wages of $1,000 or more in any calendar quarter

(Do not count cash wages paid in 2009 or 201 0 to your spouse, your child under age 21, or your parent.)

o o

No. Yes.

Stop. Do not file this schedule. Skip lines 1·9 and go to line 10 on page 2. (Calendar year taxpayers do not have to complete this form for 2010.) having no household employees in 2010

Social Security,

Medicare,

and Federal Income Taxes

1 2 3 4 5 6 7 8 9

Total cash wages subject to social security taxes (see page H-4) Social security taxes. Multiply line 1 by 12.4% (.124) Total cash wages subject to Medicare taxes (see page H-4) Medicare taxes. Multiply line 3 by 2.9% (.029) Federal income tax withheld, Total social security, if any and federal income taxes. Add lines 2, 4, and 5

1L-_1_.__1

-=5:_6=._L...;;; ,1=-5:::....::9_.'-I
.

2

6 964.

1L-3"--.__1

-=5:_6=...L-=: ,1=-5=-:::9:_.=-j
. .. 4

1 629.

5
6 1-.:..7-+

7 788. 16 381.
_

Medicare,

Advance earned income credit (EIC) payments, Net taxes (subtract line 7 from line 6)

if any......................... .. of 2009 or 2010 to all household

8

16

381.

Did you pay total cash wages of $1,000 or more in any calendar quarter

employees?

(Do not count cash wages paid in 2009 or 201 0 to your spouse, your child under age 21, or your parent.)

o
LHA

No.

Stop. Include the amount from line 8 above on Form 1040, line 59, and check box b on that line. If you are not required to file Form 1040, see the line 9 instructions on page H-4.

[XJ Yes.

Go to line 10 on page 2 Act and Paperwork Reduction Act Notice, see page H-7 of the instructions. Schedule H (Form 1040) 2010

For Privacy

010351 12-07-10

15211006

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CRUZ

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34 CRUZ,

RAFAEL

E

CRUZ

__

1

10 Did you pay unemployment

contributions

to only one state? (If you paid contributions

to a credit reduction

state, . . .

see page H-5 and check "No.") 11 Did you pay all state unemployment Next: contributions for 201 0 by April 18, 2011? Fiscal year filers, see page H-5 tax? 12 Were all wages that are taxable for FUTA tax also taxable for your state's unemployment

If you checked the "Yes" box on all the lines above, complete Section A. If you checked the "No" box on any of the lines above, skip Section A and complete Section B.

Section A
13 Name of the state where you paid unemployment 14 Contributions paid to your state unemployment contributions fund (see page H-5) ~

TX

0% RATE
1L-..C1c:.!4c..-'-1 '
00 to line 25

-I . 15 16

15 Total cash wages subject to FUTA tax (see page H-5) 16 FUTA tax. MultiplyJine 17 Complete 15 by .008. Enter the result here skij) Section Band

10

351. 83.

Section B
all columns below that apply (if ou need more space, see page H-5): (a)
Name of state

(b)
Taxable wages (as defined in state act) From

(c)
State experience period rate To

(d)
State experience rate

(e)
Multiply col. (b) by .054

(f)
Multiply col. (b) by col. (d)

Subtract col. (I) from col. (e). If zero or less, enter ·0-.

(9)

(h)
Contributions paid to state unemployment fund

18 To''''..........................................................
19 Add columns (g) and (h) of line 18 21 22 23 24 Multiply line 20 by 6.2% (.062) of line 19 or line 22 state must use the worksheet " on page H-5) 20 Total cash wages subject to FUTA tax (see the line 15 instructions Multiply line 20 by 5.4% (.054) Enter the smaller (Employers FUTA tax. Subtract in a credit reduction

r r...................
L_.!1""9....L

1L-.!:18~---,-_--,-_--'-l .

_

T

r

.

20 21

c.....=22=-'-on page H·5 and check here)

--1

D 1-'2::::3=-+
24 f--"2::.::5'-t ~26""__'

_

!iiBlmUJ'~1Total
25

line 23 from line 21. Enter the result here and 00 to line 25 .

Household Employment

Taxes

Enter the amount from line 8. If you checked

the "Yes" box on line C of page 1, enter -0-

=1:..:6:<...L..::3::,.8:::::,.::

26 Add line 16 (or line 24) and line 25 (see page H·6) 27 Are you required to file Form 10407

__=1::..:6"-L--"'4'-'6~4~.

[XJ

Yes.

Stop. Include the amount from line 26 above on Form 1040, line 59, and check box b on that line. Do not complete

Apt., room, or suite no.

City, town or post office, state, and ZIP code

Under penalties of perjury, I declare that I have examined this schedule, including accompanying statements, and to the best of my knowledge and belief, it is true, correct, and complete. No part of any payment made to a state unemployment fund claimed as a credit was, or is to be, deducted from the payments to employees. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

~

Employer's

signature

PrintlType

preparer's

name

Paid Preparer Use Only

I

Preparer's

signature

I

~
Date

Date

I

~::,ckD Firm'sEIN

if ~

I

PTIN

Firm's name ~ Firm's address ~

Phone no.

Schedule

H (Form 1040) 2010

010352 12-07-10

15211006

786859

CRUZ

2010.03060

CRUZ, RAFAEL

35

E

CRUZ

1

Form

8606
(99) ~

Nondeductible IRAs
~ See separate Attach instructions. to Form 1040, Form 1040A, or Form 1040NR.

OMS No. 1545-0074

Department of the Treasury Internal Revenue Service

2010
home)

Name. If married, file a separate form for each spouse required to file Form 8606. See the instructions.

RAFAEL E
Fill in Your Address Only .... ,. Home address (number and street,

or P.O. box if mail is not delivered to your

If You Are Filing This Form by Itself and Not With Your Tax Return Nondeductible • •

I-------------------------------------.J......----City, town or post office, state, and ZIP code to TraditionallRAs and Distributions From Traditional, SEP, and SIMPLE IRAs

Contributions

Complete this part only if one or more of the following apply. You made nondeductible contributions to a traditional IRA for 2010. You took distributions from a traditional, SEP, or SIMPLE IRA in 2010 and you made nondeductible contributions to a traditional IRA in 2010 or an earlier year. For this purpose, a distribution does not include a rollover, one-time distribution to fund an HSA, conversion, recharacterization, or return of certain contributions. You converted part, but not all, of your traditional, SEP, and SIMPLE IRAs to Roth IRAs in 2010 (excluding any portion you recharacterized) and you made nondeductible contributions to a traditional IRA in 2010 or an earlier year. contributions to traditionallRAs (see instructions) ' No for 2010, including those made for 201 0 from . . .

1 2 3

Enter your nondeductible

January 1, 2011, through April 18, 2011 (see instructions) Enter your total basis in traditionallRAs Add lines 1 and 2 In 2010, did you take a distribution 1--from traditional, SEP, or SIMPLE IRAs, 4 Enter those contributions Subtract line 4 from line 3 SEP, and SIMPLE IRAs as of rollovers (see instructions) SEP, and SIMPLE IRAs in to fund an HSA, or . included

----I~. Enter
~

the amount from line 3 on line 14. Do not complete the rest of Part I.

~o~r~m~ak~e~a~R~o~t~h~I~R~A~c~o~n~v~e~rs~i~o~n.:.? Yes __ _j_---

Go to line 4. .

on line 1 that were made from January 1, 2011, through April 18, 2011

5 6
7

Enter the value of all your traditional, Enter your distributions conversions

December 31, 2010, plus any outstanding from traditional,

2010. Do not include rollovers, a one-time distribution recharacterizations of traditional IRA contributions

to a Roth IRA, certain returned contributions, from traditional,

(see instructions) SEP, and SIMPLE that you later

8

Enter the net amount you converted recharacterized (see instructions).

IRAs to Roth IRAs in 2010. Do not include amounts converted

Also enter this amount on line 16 .

.

9
10 11 12 13 14 15

Add lines 6,7, and 8

Divide line 5 by line 9. Enter the result as a decimal rounded to at least 3 places. If the result is 1.000 or more, enter "1.000" Multiply line 8 by line 10. This is the nontaxable converted Multiply line 7 by line 10. This is the nontaxable that you did not convert to a Roth IRA Add lines 11 and 12. This is the nontaxable Subtract Taxable amount. Subtract portion of all your distributions for 2010 and earlier years . line 13 from line 3. This is your total basis in traditionallRAs portion of the amount you . . portion of your distributions to Roth IRAs. Also enter this amount on line 17

x

line 12 from line 7. If more than zero, also include this amount on 10% tax on the amount on line 15 if you were under age

Form 1040, line 15b; Form 1040A, line 11 b; or Form 1040NR, line 16b Note: You may be subject to an additional 59 112 at the time of the distribution

2010 Conversions From Traditional, SEP, or SIMPLE IRAs to Roth IRAs
Complete this part if you converted you recharacterized) part or all of your traditional,
A.
()t~

SEP, and SIMPLE IRAs to a Roth IRA in 2010 (excluding
tho n.,t ~rnn' .nt 'n,
I,

any portion

1'"
17

If

\In,

P",..t I ~nt~r tho

~rnn' ont frnrn I;n

,

,ntor

,rn

traditional,

SEP, and SIMPLE IRAs to Roth IRAs in 2010. Do not include amounts you later recharacterized SEP, or SIMPLE IRAs in 2010 or 2011 (see instructions) Part I, enter the amount from line 11. Otherwise, For Privacy Act and Paperwork Reduction

back to traditional, If you completed (see instructions)
019801 12-10-10

...................................................

16 17

20.225. O.
Form 8606 (2010)

enter your basis in the amount on line 16 see separate instructions.

.......................................................................................................................................... Act Notice,

LHA

15211006

786859

CRUZ

2010.03060

36 CRUZ. RAFAEL

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~Fo~r~m~8~6706~(~2~01~0~)~~=F~A~E==L~E~C~R~U~Z~

Pa rt II

~~~

__ ~~~~

~

__ ~~ (Continued)

~~ 18

2010 C onversions From Tra d·· I itional, SEP, or SIMPLE IRAs to R0th IRAS
amount. Subtract line 17 from line 16
............................................

18 19

Taxable

................................................

20 225.

20a

Amount subject to tax in 2010. Check the box if you elect to report the entire taxable amount in 2010 rather than reporting 1/2 of it in 2011 and 1/2 in 2012. Generally, you must check this box if you check [XJ the box on line 24 (see instructions) ....................................... .......................................................... If you checked the box, enter the amount from line 18 on this line and include this amount on Form 1040, line 15b, Form 1040A, line 11b, or Form 1040NR, line 16b. If you did not check the box, skip line 19 and go to line 20a. Amount subject to tax in 2011. If you did not check the box on line 19, multiply the amount on line 18 by 50% (.50) and enter it here. Include this amount on the applicable line of your 2011 tax return

19 20a 20b

20 225.

........................
line

b Amount

subject

to tax in 2012. Subtract

line 20a from line 18. Include this amount on the applicable
_

of your 2012 tax return

.........................................

...... ...... _ ........................................................................

PartUl

2010 Rollovers From Qualified Retirement Plans to Roth IRAs and In-plan Rollovers to Designated Roth Accounts Complete this part if you rolled over part or all of your qualified retirement plan to a Roth IRA (excluding recharacterizations),
or rolled over an amount to a deslonated Roth account within the same plan, in 2010 to traditionallRAs , "" .. """."." " .. ".".""""" """"""." .. "." "." " " ".""."" ,,"",, .. " ,, ,, " " ". in j-!2::..!1~ f-...!'22=-+j-!2:!:3~ _ _ _ plans to Roth IRAs and any in-plan rollovers to

21

Enter the amount you rolled over from qualified retirement designated 20100r2011 Roth accounts, (see instructions) Subtract line 22 from line 21

in 2010. Do not include amounts you later recharacterized

22 23 24

Enter your basis in the amount on line 21 Taxable Amount amount. subject

to tax in 2010. Check the box if you elect to report the entire taxable amount in 2010 rather " " "" .. ""." 17b .. " "" " .. "." .. "" "............................ " "

than reporting If you checked

1/2 of it in 2011 and 1/2 of it in 2012. Generally, you must check this box if you checked the box

on line 19 (see instructions) line 16b, Form 1040A,line 25a Amount subject subject

D

the box, enter the amount from line 23 on this line and include this amount on Form 1040, 12b, or Form 1040NR,Iine """.".""."""" ". 1-=2:.:4-+ _

If you did not check the box, skip line 24 and go to line 25a. to tax in 2011. If you did not check the box on line 24, multiply the amount on line 23 by line of your 2011 tax return line 25b ".""."."" "." ".... "........................ 1-25=a=-+ _ to tax in 2012. Subtract "" line 25a from line 23. Include this amount on the applicable " .. " " .. """."" 50"/0 (.50) and enter it here. Include this amount on the applicable b Amount of your ~012. tax r~turn

Part;l"

(see instructions) Complete this part only if you took a distribution from a Roth IRA, and for certain distributions from a designated Roth account, in 2010, For this purpose, a distribution does not include a rollover, a one- time distribution to fund an HSA, recharacterization, or return of certain contributions (see instructions). distributions from a Roth IRA in 2010, including any qualified first-time homebuyer (see instructions)
..................................................................

Distributions

From Roth IRAs (and Certain Distributions from DeSignated Roth Accounts

26 27 28

Enter your total nonqualified distributions, Subtract Subtract Qualified first-time

and certain qualified distributions home buyer distributions

26 27 28

(see instructions). (see instructions)

Do not enter more than $10,000
........
___

........................

line 27 from line 26. If zero or less, enter ·0· and stop here

..... ___ .. ___

... _. ___ ... __ ....... - ..................

29
30 31 32 Note. 33 34

Enter your basis in Roth IRA contributions you may be subject retirement Subtract

.......... " ...............................................................
...........................................................................

29
30 31 32

line 29 from line 28. If zero or less, enter ·0· and stop here. If the amount is more than zero, to an additional tax (see instructions) from traditional,
_._

Enter your basis in conversions

SEP, and SIMPLE IRAs and rollovers from qualified
..........................................................................................

plans to a Roth IRA (see instructions)

line 31 from line 30. If zero or less, enter ·0· and do not complete
lines 20a and 20b, or 25a and 25b, go to line 33. Otherwise, enter the amount

the rest of Part IV .... " .....................
line and go to line 36.

If you completed

from line 32(n

Enter the smaller of line 32 or the total of lines 20a, 20b, 25a, and 25b ............ Subtract Subtract Taxable line 33 from line 32. If zero, enter -0· and skip line 35 and go to line 36 the total of lines 17 and 22 from line 34_ If zero or less, enter ·0· amount.

I 34 I
Roth accounts,

33

r

Ci

35
36

......................................................

35

Add lines 33 and 35. If more than zero, also include this amount on Form 1040, line 15b, from designated

Form 1040A, line 11 b, or Form 1040NR, line 16b. For distributions see instructions Sign Here Only If You Are Filina This Form by Itself and Not With Your Tax Return

..........................................................................................................................................

36
and belief, it is true,

Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my knowledge correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

~

Your signature

PrinVf ype preparer's name

Paid Preparer Use Only
019802 12-10-10

I

Preparer's signature

I

~
Date

Date

Firm's name ~ Firm's address ~

I

Check

D

if

PTiN

self- employed Firm'sEIN ~ Phone no.

Form

8606 (2010)

15211006

786859

CRUZ

2010.03060

37
CRUZ, ~FAEL E CRUZ

1

Form

8889
~

Health Savings Accounts (HSAs)
Attach to Form 104{) or Form 104{)NR. ~ See separate instructions.
Attachment Sequence No.

Department of the Treasury fnternal Reyenue Service

53

Name(s) shown on Form 1040 or Form 1040NR

Social security number of HSA beneficiary. If both spouses have HSAs, see instructions ~

Before you begin:

Complete Form 8853, Archer MSAs and Long-Term Care Insurance Contracts,

if required.

IPart II

HSA Contributions

and Deduction.

See the instructions

before completing

this part. If you are filing jointly and both you and

your spouse each have separate HSAs, complete

a separate Part I for each spouse.

Check the box to indicate your coverage under a high-deductible 2010 (see instructions) 2 HSA contributions contributions, instructions) 3 you made for 201

health plan (HDHP) during ~

Dr==,-S=:.e;:.:lf,-.o::..:n-,,-IL-__,I=~I.:...F.=a:..:.m::.

a (or those

made on your behalf), including those made

from January 1, 2011, through April 18, 2011, that were for 201 O. Do not include employer contributions through a cafeteria plan, or rollovers (see 1--'2=-+an eligible individual with the same coverage, enter $3,050 ($6,150 for for the amount to enter to your Archer MSAs for 2010 from Form Archer MSAs . . for the " contribution amount 1-7'--+. made to your HSAs for 2010 . . . . tax (see page 5 of the _ 4 t--3=c_+_ _

If you were under age 55 at the end of 2010, and on the first day of every month during 2010, you were, or were considered, family coverage). All others, see the instructions

4

Enter the amount you and your employer contributed 2010, also include any amount contributed

8853, lines 1 and 2. If you or your spouse had family coverage under an HDHP at any time during to your spouse's

5 6

Subtract

line 4 from line 3. If zero or less, enter -0-

5

Enter the amount from line 5. But if you and your spouse each have separate HSAs and had family coverage under an HDHP at any time during 2010, see the instructions amount to enter

1---'6~+-

_

7

If you were age 55 or older at the end of 2010, married, and you or your spouse had family coverage under an HDHP at any time during 2010, enter your additional (see instructions)

8

Add lines 6 and 7 Employer contributions Add lines 9 and 10 Subtract line 11 from line 8. If zero or less, enter -0Enter the smaller of line 2 or line 12 here and on Form 1040, HSA deduction. Qualified HSA funding distributions

9
10 11 12 13

line 25, or Form 1040NR, line 25 Caution: If line 2 is more than line 13, you may have to pay an additional instructions).

Parton
14a

HSA Distributions.

If you are filing jointly and both you and your spouse each have separate HSAs, ' included on

,-,mnnlAtA a separate Part II for each spouse. Total distributions excess contributions you received in 2010 from all HSAs (see instructions) (and the eamings on those excess contributions) by the due date of your return (see . . (see instructions) . line 15 from line 14c. If zero or less, enter -0-. Also, include qualified medical expenses Subtract

b Distributions

included on line 14a that you rolled over to another HSA. Also include any

line 14a that were withdrawn instructions) c Subtract 15 16 Taxable

line 14b from line 14a HSA distributions.

Unreimbursed

this amount in the total on Form 1040, line 21, or Form 1040NR, line 21. On the dotted line next 17 a If any of the distributions 10% Tax(see instructions), b Additional included on line 16 meet any of the Exceptions check here Enter 10% (.10) of the distributions included on line 16 10% tax. Also include this amount in the total on Form 1040, line next to Form 1040, line 60, or Form instructions. Form 8889 to the Additional ~

0

10"10 tax (see instructions).

that are subject to the additional

line 60, or Form 1040NR, line 59. On the dotted LHA
020381

For Paperwork
12-27-10

Reduction

Act Notice,

see separate

(2010)

15211006

786859 CRUZ

2010.03060

38
CRUZ _ RAFAF.T. F.
l"'IHT7 1

Pa e2 completing this part. If you are filing jointly and both you and your spouse each have separate HSAs, complete a separate Part III for

each spouse.

18 19
20 21

Qualified HSA distribution Last-month rule

. .

18 19 20

Qualified HSA funding distribution Total income. the amount Add lines 18, 19, and 20. Include this amount on Form 1040,Iine 21, or Form 1040NR, . tax. Multiply line 21 by 10% (.10). Include this amount in the total on Form 1040, line 60,

line 21. On the dotted line next to Form 1040, line 21, or Form 1040NR, line 21, enter "HSA" and 21

22

Additional

or Form 1040NR, line 59. On the dotted line next to Form 1040, line 60, or Form 1040NR, line 59, enter "HDHP" and the amount 22 Form

8889

(2010)

020382

12-27-10

15211006

786859

CRUZ

39
2010.01060 C'RTT7. R1lF1lRT. _
R
("lHT'7.

1

Form

8582
of the Treasury Service (99)

Passive Activity Loss Limitations
~ See separate instructions. Attach to Form 1040 or Form 1041. Identifying

OMB No. 1545-1008

Department

2010
number

Internal Revenue

Name(s) shown on return

Rental Special

Real Estate Activities Allowance

With Active Participation

(For the definition

of active participation,

see

for Rental Real Estate Activities

on page 3 of the instructions.) 1, . 1, . .

1a Activities

with net income (enter the amount from Worksheet

column (a)) b Activities with net loss (enter the amount from Worksheet column (b)) c Prior years unallowed 1, column (c)) lines 1 Commercial 2a Revitalization revitalization 2, column (b) Commercial Worksheet Add All Other Passive Activities 3a Activities with net income (enter the amount from Worksheet 3, column (a)) b Activities with net loss (enter the amount from Worksheet 3, column (b)) c Prior years unallowed column (c)) 4 Combine unallowed schedules losses (enter the amount from Worksheet 3,

-45 -68
!-=2a=-+L....=2=b....J..

8.

losses (enter the amount from Worksheet and 1 Deductions deductions . From Rental Real Estate Activities from Worksheet 2, column (a) deductions from

-I

b Prior year unallowed

commercial

revitalization

-I

. . .

lines 1d, 2c, and 3d. If the result is net income or zero, all losses are allowed, including any prior year losses entered on line 1c, 2b, or 3c. Do not complete normally used • • • Line 1d is a loss, go to Part II. Line 2c is a loss (and line 1d is zero or more), skip Part" and go to Part "I. and "I and go to line 15. Line 3d is a loss (and lines 1d and 2c are zero or more), skip Parts" Form 8582. Report the losses on the forms and . .

If line 4 is a loss and:

!0f!@t1::J!iml Special Allowance
5
6 7 Enter the smaller Enter $150,000.

Caution: If your filing status is married filing separately and you lived with your spouse at any time during the year,do not complete Part /I or Part III. Instead, go to line 15.

for Rental Real Estate Activities With Active Participation
for an example. . .

Note: Enter all numbers in Part /I as positive amounts. See page 9 of the instructions of the loss on line 1d or the loss on line 4 If married filing separately, see the instructions gross income, but not less than zero (see the instr.)

Enter modified adjusted

Note: If line 7 is greater than or equal to line 6, skip lines 8 and 9, enter -0- on line 10. Otherwise, go to line 8.

S 9
10

Subtract

line 7 from line 6

.
If married filing separately, see the instructions .

Multiply line 8 by 50% (.5).00 not enter more than $25,000.

Note: Enter all numbers in Part III as positive amounts. See the example for Part /I on page 9 of the instructions.

12 13 14

Enter the loss from line 4 Reduce line 12 by the amount on line 10 Enter the smallest of line 2c (treated as a positive amount), line 11 or line 13

1--'1"'2=-+ 1-1:.:3=-+ 14 1-1:.:5'-+ 16

_ _

,MlilJlltl Total Losses Allowed
15 16 LHA Total losses allowed

Add the income, if any, on lines 1a and 3a and enter the total..................................................... from all passive activities for 2010. Add lines 10, 14, and 15. See the instructions to find out how to report the losses on your tax return
019761 01-12-11

_

BEE
see separate instructions.

S.TATEMENT ...2. 8.

o.
Form 8582 (2010)

For Paperwork

Reduction

Act Notice,

15211006 786859 CRUZ

40 2010.03060 CRUZ. RAFAEL E

CRtJ7.

1

~Fo~rm~85~8~2~(2~01~0~)~RA~F~A~E=L~~E~&~H~E~I~'D~I~~S~C~R~U~Z~
Caution: The worksheets must be filed with your tax return. Keep a copy for your records.

1111111111111
Overall gain or loss (d) Gain

Page2

Worksheet

1 - For Form 8582, lines
Name of activity

1a, 1b, and 1c

(See instructions) Prior years (c) Unallowed loss (line 1c)

Current year (a) Net income (line 1a) (b) Net loss (line 1b)

(e) Loss

SEE ATTAC HED STATEM ENT FOR WO RKSHEET
Total. Enter on Form 8582, lines 1a, 1b and 1c ................................................

1

Worksheet

~ 2 - For Form 8582, Lines 2a and 2b
Name of activity

-45 938.
(See instructions)

-68 012.
(c) Overall loss

(a) Current year deductions (line 2a)

(b) Prior year unallowed deductions (line 2b)

Total. Enter on Form 8582, lines 2a and2b ...................................................... ~
',:;

Worksheet

3 - For Form 8582, lines
Name of activity

3a, 3b, and 3c

(See instructions \ Prior years (c) Unallowed loss (line 3c) Overall gain or loss (d) Gain (e) Loss

Current year (a) Net income (Iine3a) (b) Net loss (line 3b)

Total. Enter on Form 8582,lines 3b. and3c

3a,

..

','.,
",

<

Worksheet

4 - Use this worksheet
Name of activity

if an amount

~

..

'.,',

is

~hvYYII

on Form ~i82, line 10 or 14
(a) Loss (b) Ratio

(See instructions.) (d) Subtract column (c) from column (a)

Form or schedule and line number to be reported on (see instructions)

(c) Special allowance

Total .......................................

" .. ,...........................................

~
(See instructions)

Worksheet

5 - Allocation
Name of activity

of Unallowed

Losses

Form or schedule and line number to be reported on (see instructions)

(a) Loss

(b) Ratio

(c) Unallowed

loss

SEE ATTACHED
Total
019762

STATEMENT

FOR WORKSHEE'I 5 Form (2010) 8582
("DTT'7 1

.....................................
01-12-11

,.............................................................

~

113 950. 1.000000000 41
(,lHT'Z ~ n.li'l,I:;'T.
li'

113 950.

15211006

786859 CRU7.

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~Fo~rm~85~8~2~(2~01~0~)~RA~F~A~E~L~E~&~~H~E~I~D~I=-~S~C~R~u~z~
Worksheet 6 - Allowed Losses
Name of activity (See instructions.) Form or schedule and line number to be reported on (see instructions)

~1IIIIIIIIIIIII
(b) Unallowed loss (c) Allowed

Page3
loss

(a) Loss

EE ATTACHE
Total Name of activity: ~

STATEMENT

FR

113 950.
(d) Unallowed loss (e) Allowed loss

(a)

Form or schedule and line number to be reported on (see instructions): 1a Net loss plus prior year unallowed loss from form or schedule b Net income from form or schedule Subtract line 1b from line 1a. If zero or and line number . .. ......... ....... . line 1b from line 1a. If zero or ~ ~ ~ .

Form or schedule to be reported instructions):

on (see

1a Net loss plus prior year unallowed loss from form or schedule b Net income from form or schedule Subtract

Form or schedule and line number to be reported on (see instructions): 1a Net loss plus prior year unallowed loss from form or schedule b Net income from form or schedule ~ 1a. If zero or less enter -0· .......... .... .. .. ~ .

c

Form582 8 (2010)

019763 01-12-11

15211006

786859 CRUZ

?01 0 _ O':tOhO

42
C''RTT7.. 'RlI.FlI.'RT. 'R

f"lHT7.

1

Form

8844
of the Treasury

Empowerment Zone and Renewal Community Employment Credit

OM8 No. 1545-1444

Department

Attachmen~o.

2010 99
--

Name(s) shown on return

Identifying number

Enter the total qualified wages paid or incurred during calendar year 2010 only (see instructions) a Qualified empowerment zone wages............ ...

$

~-

X 20% (.20) I--'-=--t-----~.........,~..,_..-

b Skip line 1b......................................... $ X 0% (.00) 2 Enter the amount from line ta, See instructions for the adjustment you must make to salaries and wages 3 Empowerment zone and renewal community employment credit from partnerships, S corporations, cooperatives, estates, and trusts 4 5 6
7

Add lines 2 and 3. Partnerships and S corporations, report this amount on Schedule K; all others, go to line 5 . Empowerment zone and renewal community employment credit included on line 4 from passive activities (see instructions) Subtract line 5 from line 4 Passive activity credit allowed for 2010 (see instructions) Carryforward of empowerment zone and renewal community employment credit to 2010 Carryback of empowerment zone employment credit from 2011 (see instructions) Add lines 6 through 9. Cooperatives, estates, and trusts, go to line 11. All others, report this amount on Form 3800, line 24 . .

8
9 10 11

12
For Paperwork Reduction Act Notice, see instructions.

Form 8844 (2010)

LHA
020361 01-28-11

43

15211006

786859

CRUZ

2010.03060

CRUZ. RAFAEL

E

CRUZ

1

Form

8903
2010)

OMS No. 1545-1984

(Rev. December

Domestic Production Activities Deduction
~ Attach to your tax return. ~ See separate instructions.
Attachment No.

Department of the Treasury Internal Revenue Service

143

Name( s) as shown on return

Identifying number

Note. Do not complete 1 2 3 4 Domestic production

column (a). unless you have oil-related production

activities. activities.

(a) ~~~~~~~IQ!:!~!!.'{!~~ __ ~~~~~:-:_

Enter amounts for all activities in column (b), including oil·related production gross receipts (DPGR) Allocable cost of goods sold. If you are using the small business simplified overall method, skip lines 2 and 3 Enter deductions and losses allocable to DPGR (see instructions) If you are using the small business simplified of cost of goods sold and other deductions DPGR. All others, skip line 4

. . to . overall method, enter the amount or losses you ratably apportion

4.

5
6 7

Add lines 2 through 4 Subtract line 5 from line 1 activities income from estates, trusts, and certain partnerships (see instructions) . Qualified production and S corporations

8
9 10a

Add lines 6 and 7. Estates and trusts, go to line 9, all others, skip line 9 and go to line 10 Amount allocated to beneficiaries Oil-related qualified production of the estate or trust (see instructions) activities income. Estates and trusts, subtract . Estates and trusts, subtract 21, and enter -0· on line 22 line 9, column

10.

line 9, column (a), from line 8, column (a), all others, enter amount from line 8, column (a). If zero or less, enter -0- here

b Qualified

production

activities

income.

(b), from line 8, column (b), all others, enter amount from line 8, column (b). If zero or less, enter ·0· here, skip lines 11 through 11 Income limitation (see instructions): • • ~nod;~~~i:l~r::~;::~ a;~i:~::s~~~~e;t:nu~. ~~j.~.s~~~." " ~~~.~.~~.ig.~.re~.~i.th.~.ut."'. f production . .. .}

All others. Enter your taxable income figured without the domestic activities deduction (tax-exemot organizations, see instructionsL

11

840.

12 13
14a b

Enter the smaller of line 1Db or line 11. If zero or less, enter -0· here, skip lines 13 through 21, and enter ·0· on line 22 Enter go/o of line 12 Enter the smaller of line 1Oa or line 12 Reduction for cit-related qualified production Subtract line 14b from line 13 .. and S corporations (see . .. .. . Enter deduction from Form . to beneficiaries of the estate or trust (see instructions) Form W·2 wages (see instructions) Form W·2 wages from estates, trusts, and certain partnerships instructions) activities . income. Multiply line 14a by 3% 14a

15 16
17 18 19

Add lines 16 and 17. Estates and trusts, go to line 19, all others, skip line 19 and go to line 20 Amount allocated Estates and trusts, subtract Form W·2 wage limitation. Domestic production 1099·PATR, box 6 line 19 from line 18, all others, enter amount from line 18 Enter 50% of line 20 from cooperatives.

20 21
22

Enter the smaller of line 15 or line 21 activities deduction

23

LHA

For Paperwork

Reduction

Act Notice,

see separate

instructions.

Form 8903 (Rev. 12-2010)

010911 12-29-10

15211006

786859

CRUZ

2010.03060

CRUZ, RAFAEL

44

E

CRUZ

1

Qualified Production Activity Income Schedule
Name RAFAEL E & HEIDI S CRUZ uornesnc Production Gross ~~~~~~s lISE
rrn'l'Ar, rrn'l'ZlT. FRnM OUALIFIED [RS

JIIIiii
Di~
exoenses

Interesy Other Costs 2 2 2 Apportioned Expenses Allocable Assets

'-"1-''''' ,,,.,

Ub'

,"",,"VI

'"'I-'

.lI.1 JV"""" "" Assets Ratio

"'
Interest Expense

DPGR Ratio

Costs of Goods Sold

Total Qualified Expenses 6

Qualified Production Activity Income

~ ,~~ .. , AI

p,

NON-OUALIFIED

:El

16 1,764568 1 764.584 16

,00000
,99999

4 4

0 0 0

0 6
6

_].Q_

,000009

4

--0

10

008501 05-01-10

45

Form

8283

Noncash Charitable Contributions
~ Attach to your tax return if you claimed a total deduction of over $500 for all contributed property. instructions.

OMB. No. 1545-0908

(Rev.December2006) Department01 theTreasury Name(s) shown on your income tax return

Attachment SequenceNo.

155

Identifying number

Section A. Donated Property of $5,000 or Less and Certain Publicly Traded Securities - List in this section only items (or groups of similar items) for which you claimed a deduction of $5,000 or less. Also, list certain publicly traded securities even if the deduction is more than $5,000 (see instructions).

r,f)arffl
1 A

Information on Donated Property - If you need more space ,attach a statement (a) Name and address of the donee organization (b) Description of donated property
(For a donated vehicle,

and attachForm 1098-C il required.)

enter the year, make. model,

condition,

and mileage,

B

c
D E

Note. If the amount YOU claimed as a deduction for an item is $500 or less, you do not have to com! lete columns (d), (e), and (I). (e)Howacquired (c 1Dateolthe ~d) Dateacquired (f) Donor'scost or (h) Method u~~~ ~::~~mine the fair (gl {~: ~~.:'~tr;~~i contribution by donor adjusted basis 'Y donor(mo.,vr.) VARIOUS A VAR. PURCHASE 600. 200. THRIFT SHOP VALUE

GOODWILL INDUSTRIES 1015 NORWOOD PARK BLVD., GOODWILL INDUSTRIES 1015 NORWOOD PARK BLVD. GOODWILL INDUSTRIES 1015 NORWOOD PARK BLVD. GOODWILL INDUSTRIES 1015 NORWOOD PARK BLVD. GOODWILL INDUSTRIES 1015 NORWOOD PARK BLVD.

AUSTIN AUSTIN AUSTIN AUSTIN AUSTIN

TX 78753 ~LOTHING/HOUSEWARES TX 78753 ~LOTHING/HOUSEWARES TX 78753 ~LOTHING/HOUSEWARES TX 78753 CLOTHING/HOUSEWARES TX 78753 CLOTHING/HOUSEWARES

B
C D E

t#,j'iill~ Partial

VARIOUS VARIOUS VARIOUS VARIOUS

VAR. VAR. VAR. VAR.

PURCHASE PURCHASE PURCHASE IPURCHASE

2 895. 2,625. 300. 3 180.

965. THRIFT 875. THRIFT 100. THRIFT 1 060. THRIFT

SHOP SHOP SHOP SHOP

VALUE VALUE VALUE VALUE

Interests and Restricted Use Property - Complete lines 2a through 2e if you gave less than an entire interest in a property listed in Part I. Complete lines 3a through 3c if conditions were placed on a contribution listed in Part I; also attach the required statement (see instructions). ~ ~ ~ _ _ _

2 a Enter the letter from Part I that identifies the property for which you gave less than an entire interest If Part II applies to more than one property, attach a separate statement. b Total amount claimed as a deduction for the property listed in Part I: (1) For this tax year (2) For any prior tax years c

Name and address of each organization to which any such contribution was made in a prior year (complete only if different from the donee organization above): Nameof charitableorganization(donee) Address(number,street,and roomor suiteno.) City or town, state,and ZIP code

d e

For tangible property, enter the place where the property is located or kept ~ Name of any person, other than the donee organization, having actual possession of the property ~ --._--.

_ __

b

Did you give to anyone (other than the donee organization or another organization participating with the donee organization in cooperative fundraising) the right to the income from the donated property or to the possession of the property, including the right to vote donated securities, to acquire the property by purchase or otherwise, or to designate the person having such income, possession, or right

c

to acquire? , Is there a restriction limiting the donated

,

. Form 8283 (Rev. 12-2006)

LHA For Paperwork Reduction Act Notice, see separate instructions.
019931 05-01-10

15211006

786859

CRUZ

2010.03060

46 CRUZ_ RAFAF.T.F.

r'RTT7.

1

Form 1116
NAME

U.S. and Foreign Source Income Summary

~RA~F~A~E~L~E~&~H~E~I~D~I~S~C~R~U~Z~
INCOME TYPE Compensation Dividends/Distributions Interest Capital Gains Business/Profession Rent/Royally StatelLocal Refunds Partnership'S Corporation TrustlEstate Other Income Gross Income TOTAL

~1111111111111_
FOREIGN

u.S.

SEE STATEMENT

34

360,290. 8,742. 2,957. 1,502. 46,386. 6,204. 3,170,285. 31,725. 3,628,091.

360,290. 8,643. 2,957. 1,502. 46,386. 6,204. 3,002,384. 31,725. 3,460,091.

GENERAL 99.

SEE STATEMENT

35

167,901. 168,000.

Less: Section 911 Exclusion Capital Losses Capital Gains Tax Adjustment Total Income - Form 1116

4,502. 3,623,589.

4,502. 3,455,589.

30. 167,970.

Deductions: Business/Profession Expenses RentiRoyally Expenses Partnership/S Corporation Losses TrustlEstate Losses Capital Losses Non-capital Losses Individual Retirement Account Moving Expenses Self-employment Tax Deduction Self-employment Health Insurance Keogh Contributions Alimony Forfeited Interest Foreign Housing Deduction Other Adjustments Capital Gains Tax Adjustment Total Deductions Adjusted Gross Income Less Itemized Deductions: Specifically Allocated Home Mortgage Interest Other Interest Ratably Allocate!! Total Adjustments to Adjusted Gross Income Taxable Income Before Exemptions

1,452,103. 46,386.

1,306,430. 46,386.

145,673.

30,265. 4,995. 49,000.

30,265. 4,995. 49,000.

1,582,749. 2,040,840. 22,337. 80,821. 111,466. 214,624. 1,826,216.

1,437,076. 2,018,513. 22,337. 77,079. 106,305. 205,721. 1,812,792.

145,673. 22,297.

3,742. 5,161. 8,903. 13,394.

027931 05-01-10

15211006

786859

CRUZ

2010.03060

CRUZ.

47

RAFAEL

F.

(,RTT'7.

1

Form 1116
NAME

Allocation of Itemized Deductions

RAFAEL

E & HEIDI
Total Itemized Deductions Itemized Deductions After Sec. 68 Reduction Form 1116 Specifically Foreign Ratable

Specifically U.S.

Taxes Interest - Not Including Investment Interest Contributions Miscellaneous Deductions Subject to 2% Other Miscellaneous Deductions Not Including Gambling Losses Foreign Adjustment Totalltemized Deductions Subject to Sec. 68 Add Itemized Deductions Not Subject to Sec. 68: MedicaVDental Investment Interest Casualty Losses Gambling Losses Foreign Adjustment Total Itemized Deductions Total Allowed on Schedule A . . .

.

111

6. 2.

111 466.

.

.

.

.

21

027871 10-13-10

15211006

786859

CRUZ

2010.03060

48 CRUZ. RAFAEL E

~"RTT7.

1

Form 1116
NAME

Foreign Tax Credit Carryover Statement (Page 1 of 2)

~RA~F=A=E=L~E~&~H=E~I=D~I~S~C~R~U~Z~
Foreign Income Category Regular 1. Foreign tax paid/accrued 2. FTC carryback to 2010 I· for amended returns 3. Reduction allocated to excluded income ....... 4. Foreign tax available ... 5. 6. 7. 8. 10. Maximum credit allowable Unused foreign tax ( + ) or excess of limit ( -) ... Foreign tax carryback ... Foreign tax carryforward Foreign tax or excess limit remaining ............ Total foreign taxes from all available years to be carried to next year .
................................... .:

~IIIIIIIIIIIII--PENERAL LIMITATION
2009
i}

INCOME
2010

2005

2006

2007

2008

, i.i.·.·.··.•·..
...;
.r
.....

..

<

9,035.

i.

.....

« .•
,:;

C

o.

.

9,035. 4 432. 4 603.

Ii'· ••
..:

-:

9. Less treaty adjustment

t. 'i.i.
........... ..............

.' .•.•..•..• i'. /
- __ .....

>••"

. ....

4 603. 4 603.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Foreign tax paid/accrued FTC carryback to 2010 for amended returns Reduction allocated to excluded income Foreign tax available Maximum credit allowable Unused foreign tax ( + ) or excess of limit ( -) ..... Foreign tax carryback . Foreign tax carryforward Less treaty adjustment Foreign tax or excess limit remaining . .. .. . . . . .

027915

05-01·10

15211006

786859

CRUZ

2010.03060

49 CRUZ, RAFAEL

E

CRUZ

1

Form 1116
NAME

Foreign Tax Credit Carryover Statement

(Page 2 of 2)

~RA~F~A~E=L~E-=&-=H=E~I~D~I-=S~C~R~U=Z
Foreign Income Category AMT 1. Foreign tax paid/accrued 2. FTC carryback to 2010 for amended returns 3. Reduction allocated to excluded income 4. Foreign tax available 5. 6. 7. 8. Maximum credit allowable Unused foreign tax ( + ) or excess of limit ( -) . Foreign tax carryback . Foreign tax carryforward

IIIIIIIIIIII___
~ENERAL LIMITATION INCOME

1----........~

~..G.4-..G...G...G...G...G.G~

........ -------_+--------+_'-"-'-..G...G...G...G..:+---;~..JJ~~

9. Less treaty adjustment 10. Foreign tax or excess limit remaining . . . Total foreign taxes from all available years to be carried to next year ..

1. Foreign tax paid/accrued 2. 3. 4. 5. 6. 7. 8. 9. FTCcarryback to 2010 for amended returns Reduction allocated to excluded income Foreign tax available Maximum credit allowable Unused foreign tax ( + ) or excess of limit ( -) Foreign tax carryback Foreign tax carryforward Less treaty adjustment limit remaining . . . .

10. Foreign tax or excess .

027916 05-01-10

15211006

786859

CRUZ

2010.03060

50 CRUZ, RAFAEL

E

CRUZ

1

Form 1116
NAME

Foreign Wages, Salaries, Business and Profession Income

Wages and Salaries:

~RA~F~A~E~L~E~&~H=E=I=D~I~S~C~R~U~Z
Source Amount

~1111111111111_

Total Foreign Wages and Salaries

.

Business and Profession Income: Source Amount

MORGAN,

LEWIS

& BOCKIUS LLP

167,901.

Total Foreign Business and Profession Income

"

.

167,901.

Reduction for Foreign Earned Income Exclusion/Deduction: Total Foreign Wages and Salaries '" Foreign Earned Income Exclusion/Deduction Percent Applicable to Foreign Wages and Salaries . . .

Reduction Amount Wages and Salaries Included on Form 1116, line 1 Total Foreign Business and Profession Income Foreign Earned Income Exclu . . Percent Applicable to Foreign Business and Profession Income Reduction Amount Business and Profession Income Included on Form 1116, line 1 . .. . . .

167,901.

027531 05-01-10

15211006

786859

CRUZ

2010.03060

51 CRUZ, RAFAEL

E

CRUZ

1

RAFAEL FORM 1040

E & HEIDI S CRUZ MISCELLANEOUS INCOME STATEMENT AMOUNT FUND-AWARD 1,000. 10,000. 500. 11,500.
1

DESCRIPTION THE FEDERALIST SOCIETY NRA CIVIL RIGHTS DEFENSE FAITH WEST ACADEMY

TOTAL TO FORM 1040, LINE 21

FORM 1040

STATE AND LOCAL

INCOME TAX REFUNDS 2009 2008

STATEMENT 2007

2

GROSS STATE/LOCAL INC TAX REFUNDS LESS: TAX PAID IN FOLLOWING YEAR NET TAX REFUNDS CALIFORNIA

CALIFORNIA 6,068.

6,068. NEW YORK 136.

GROSS STATE/LOCAL INC TAX REFUNDS LESS: TAX PAID IN FOLLOWING YEAR NET TAX REFUNDS NEW YORK

136. 6,204.

TOTAL NET TAX REFUNDS

')010

_ 01.0':;0

('I~TT'Z

52

STATEMENT(S)
~lI.l4'lI.'RT. 'R ('I~TT'Z

1, 2
1

RAFAEL FORM 1040

E & HEIDI S CRUZ TAXABLE STATE AND LOCAL INCOME TAX REFUNDS 2009 2008 STATEMENT 2007 3

NET TAX REFUNDS FROM STATE AND LOCAL INCOME TAX REFUNDS STMT. LESS:REFUNDS-NO BENEFIT DUE TO AMT -SALES TAX BENEFIT REDUCTION 1 2 3 4 5 6 7 8 9 NET REFUNDS FOR RECALCULATION

6,204.

6,204. 154,214. 6,204. 148,010. 39,469. 1,500,387. 166,800. 1,333,587.

TOTAL ITEMIZED DEDUCTIONS BEFORE PHASEOUT DEDUCTION NOT SUBJ TO PHASEOUT NET REFUNDS FROM LINE 1 LINE 2 MINUS LINES 3 AND 4 MULT LN 5 BY APPL SEC. 68 PCT PRIOR YEAR AGI ITEM. DED. PHASEOUT THRESHOLD SUBTRACT LINE 8 FROM LINE 7 (IF ZERO OR LESS, SKIP LINES 10 THROUGH 15, AND ENTER AMOUNT FROM LINE 1 ON LINE 16) MULT LN 9 BY APPL SEC. 68 PCT ALLOWABLE ITEMIZED DEDUCTIONS (LINE 5 LESS THE LESSER OF LINE 6 OR LINE 10) ITEM DED. NOT SUBJ TO PHASEOUT

10 11 12

13,336. 134,674.

13A TOTAL ADJ. ITEMIZED DEDUCTIONS 13B PRIOR YR. STD. DED. AVAILABLE 14 PRIOR YR. ALLOWABLE ITEM. DED. 15 16 17 18 19 20 21 22 SUBTRACT THE GREATER OF LINE 13A OR LINE 13B FROM LINE 14 TAXABLE REFUNDS (LESSER OF LINE 15 OR LINE 1) ALLOWABLE PRIOR YR. ITEM. DED. PRIOR YEAR STD. DED. AVAILABLE SUBTRACT LINE 18 FROM LINE 17 LESSER OF LINE 16 OR LINE 19 PRIOR YEAR TAXABLE INCOME

134,674. 12,400. 140,878. 6,204. 6,204. 140,878. 12,400. 128,478. 6,204. 1,352,210.

AMOUNT TO INCLUDE ON FORM 1040, LINE 10 * IF LINE 21 IS -0- OR MORE, USE AMOUNT FROM LINE 20

* IF LINE

21

IS

A-NEGATIVE

AMOtJNT, NET--J::rI-NE-S-2-9---ANB-2-1--~_~--_-~----~-~~--6,-2~4--.----_

STATE AND LOCAL TOTAL TO FORM

INCOME

TAX REFUNDS 10

PRIOR TO 2007 6,204.

1040, LINE

?n1 n n~nt:n

("loon.,.

53

STATEMENT(S)
'0 21. 1<'21. 1<'T_ 1<' "''OTT.,. 1

3

RAFAEL FORM 1040

E & HEIDI S CRUZ IRA DISTRIBUTIONS GROSS DISTRIBUTION 8606 20,225. 20,225. STATEMENT
4

NAME OF PAYER - FROM FORM

TAXABLE

AMOUNT 20,225. 20,225.

TOTAL TO FORM 1040, LINE 15

FORM 1040 NAME OF PAYER GOLDMAN SACHS & CO.

TAX-EXEMPT

INTEREST

STATEMENT AMOUNT

5

6,582. 6,582.

TOTAL TO FORM 1040, LINE 8B

15211006

786859

CRTJ7.

?n1 n _o vnsn

54
(,lUT'?. Rnli'nRT. R

STATEMENT(S)

(,RTT7.

4, 5
1

RAFAEL FORM 1. 2. 3. 1040

E

&

HEIDI S CRUZl STUDENT LOAN INTEREST DEDUCTION STATEMENT 6

ENTER THE TOTAL INTEREST PAID IN 2010 ON QUALIFIED STUDENT LOANS. DO NOT ENTER MORE THAN $2,500 ...... . .. ENTER THE AMOUNT FROM FORM 1040, LINE 22 .

676. 2,125,100.

ENTER THE TOTAL OF THE AMOUNTS FROM FORM 1040, LINES 23 THROUGH 32 PLUS ANY WRITE-IN ADJUSTMENTS YOU ENTERED ON THE DOTTED LINE NEXT TO LINE 36 . . . . . •. ... SUBTRACT LINE 3 FROM LINE 2

..

84,260. 2,040,840.

4. 5.

ENTER THE AMOUNT SHOWN BELOW FOR YOUR FILING STATUS. * SINGLE, HEAD OF HOUSEHOLD, OR QUALIFYING WIDOW(ER)-$60,000 * MARRIED FILING JOINTLY-$120,000 .•......•.• IS THE AMOUNT ON LINE 4 MORE THAN THE AMOUNT ON LINE 5? [ ] NO. SKIP LINES 6 AND 7, ENTER -0- ON LINE 8, AND GO TO LINE 9 [X] YES. SUBTRACT LINE 5 FROM LINE 4 .........• DIVIDE LINE 6 BY $15,000 ($30,000 IF MARRIED FILING JOINTLY). ENTER THE RESULT AS A DECIMAL (ROUNDED TO AT LEAST THREE PLACES). IF THE RESULT IS 1.000 OR MORE, ENTER 1.000 ••. MULTIPLY LINE 1 BY LINE 7 .

120,000.

6.

1,920,840.

7.

1.000 676.

8. 9.

STUDENT LOAN INTEREST DEDUCTION. SUBTRACT LINE 8 FROM LINE 1. ENTER THE RESULT HERE AND ON FORM 1040, LINE 33

O.

FORM 1040

WAGES

RECEIVED

AND TAXES WITHHELD STATE TAX WITHHELD CITY SDI TAX W/H

STATEMENT

7

T

S EMPLOYER'S S GOLDMAN, TOTALS

NAME SACHS & CO.

AMOUNT PAID 360,290. 360,290.

FEDERAL TAX WITHHELD 99,003. 99,003.

FICA TAX 6,622. 6,622.

MEDICARE TAX 5,696. 5,696.

15211006

786859

CRUZ

?01 0 _01060

55
C'RTJ7. _ RA.FA.F.T. F.

STATEMENT(S)
C'RTT7.

6, 7
1

RAFAEL FORM 1040

E & HEIDI S CRUZ\ QUALIFIED DIVIDENDS ORDINARY DIVIDENDS 59. 6,121. 2,562. STATEMENT QUALIFIED DIVIDENDS 59. 5,052. 5,113. 8

NAME OF PAYER THE GOLDMAN SACHS GROUP, INC. GOLDMAN SACHS & CO. FROM K-1 - MORGAN, LEWIS & BOCKIUS LLP TOTAL INCLUDED IN FORM 1040, LINE 9B

2.

FORM 1040
T

FEDERAL INCOME TAX WITHHELD

STATEMENT

9

S DESCRIPTION
J

AMOUNT INC. 99,003. 8. 99,011.

S GOLDMAN, SACHS & CO. THE GOLDMAN SACHS GROUP, 61

TOTAL TO FORM 1040, LINE

SCHEDULE

A

STATE AND LOCAL

INCOME

TAXES

STATEMENT AMOUNT

10

DESCRIPTION FROM K-1 - MORGAN, LEWIS & BOCKIUS LLP PAID VIA PASSTHROUGH - MORGAN LEWIS TOTAL TO SCHEDULE A, LINE 5

55,011. 23,164. 78,175.

SCHEDULE

A

CASH CONTRIBUTIONS AMOUNT 50% LIMIT LEWIS

STATEMENT AMOUNT 30% LIMIT

11

DESCRIPTION VARIOUS CHARITIES FROM K-1 - MORGAN, SUBTOTALS TOTAL TO SCHEDULE A, LINE 16

& BOCKIUS LLP

18,398. 739. 19,137. 19,137.

15211006

786859 CRUZ

? 0 1 0 . 0 ~ 0 fi 0

56
("lHT7. R

nl<'2U'~T.

STATEMENT(S)
J;'

8, 9, 10, 11
1

RAFAEL SCHEDULE

E & HEIDI S CRUZi A MORTGAGE INTEREST AND POINTS REPORTED ON FORM 1098 STATEMENT 12

DESCRIPTION HOME MORTGAGE HOME MORTGAGE INTEREST INTEREST A, LINE 10

AMOUNT 48,421. 32,400. 80,821.

TOTAL TO SCHEDULE

SCHEDULE

B

TAX-EXEMPT

INTEREST

STATEMENT AMOUNT

13

NAME OF PAYER GOLDMAN SACHS & CO. INTEREST TO SCHEDULE B, LINE 1

6,582. 6,582.

TOTAL TAX-EXEMPT

SCHEDULE

D

NET LONG-TERM GAIN OR LOSS FROM PARTNERSHIPS, S CORPORATIONS, AND FIDUCIARIES OF ACTIVITY GAIN OR LOSS -17. -17.

STATEMENT

14

DESCRIPTION MORGAN,

28% GAIN

LEWIS

& BOCKIUS LLP
D, PART II, LINE 12

TOTAL TO SCHEDULE

15211006

786859

CRUZ

2010.03060

57 CRUZ _

STATEMENT(S)
RAFART. R

12, 13, 14
01HT7. 1

RAFAEL SCHEDULE

E & HEIDI S CRUZ" D CAPITAL LOSS CARRYOVER STATEMENT 15

1. ENTER THE AMOUNT FROM FORM 1040, LINE 41 •.••.•. 2. ENTER THE LOSS FROM SCHEDULE D, LINE 21, AS A POSITIVE 3. COMBINE LINES 1 AND 2. IF ZERO OR LESS, ENTER -04. ENTER THE SMALLER OF LINE 2 OR LINE 3 .••.•. 5. ENTER THE LOSS FROM SCHEDULE D, LINE 7, AS A POSITIVE 6. ENTER THE GAIN, IF ANY, FROM SCHEDULE D,
LINE 15 . . . . . . . . . . . . . . . . . . . . .

AMOUNT.

1,826,216. 3,000. 1,829,216. 3,000. 9,256. 3,000. 6,256. 23,126.

AMOUNT.

7. ADD LINES 4 AND 6 .•• •.••••.•••••.•... 8. SHORT-TERM CAPITAL LOSS CARRYOVER TO NEXT YEAR. SUBTRACT LINE 7 FROM LINE 5. IF ZERO OR LESS, ENTER -0... 9. ENTER THE LOSS FROM SCHEDULE D, LINE 15, 10. ENTER THE GAIN, IF ANY, FROM SCHEDULE D, LINE 7 11. SUBTRACT LINE 5 FROM LINE 4. IF ZERO OR ENTER -012. ADD LINES 10 AND 11 13. LONG-TERM CAPITAL LOSS CARRYOVER TO NEXT SUBTRACT LINE 12 FROM LINE 9. IF ZERO OR AS A POSITIVE AMOUNT.

..... . .···· .... . ···· ····

· · · · LESS,· ·· ·······. ·······

YEAR. LESS, ENTER

...
-0-

.

23,126.

15211006 786R5q

~R"~

,)010_

O~OhO

58
l"''RTT'7. 'R:alf':aH'T. H'

STATEMENT(S)

15
1

RAFAEL SCHEDULE CONDO

E & HEIDI S CRUZ, E OTHER EXPENSES PKWY UNIT 2606, HOUSTON, TX 77019 AMOUNT ASSOC DUES E, PAGE 1, LINE 18 6,536. 6,536. STATEMENT 16

- 3333 ALLEN

DESCRIPTION HOMEOWNERS'

TOTAL TO SCHEDULE

SCHEDULE

SE

NON-FARM

INCOME

STATEMENT AMOUNT

17

DESCRIPTION MORGAN, LEWIS & BOCKIUS LLP THE FEDERALIST SOCIETY NRA CIVIL RIGHTS DEFENSE FUND-AWARD FAITH WEST ACADEMY TOTAL TO SCHEDULE
SEt

1,759,161. 1,000. 10,000. 500. 1,770,661.

LINE 2

SCHEDULE

SE

OTHER ADJUSTMENTS

STATEMENT AMOUNT

18

DESCRIPTION SE HEALTH INSURANCE DEDUCTION SE, LINE 3

-4,995. -4,995.

TOTAL ADJUSTMENTS

TO SCHEDULE

15211006

786859

CRUZ

2010.03060

59
CRUZ. RAFAEl. E

STATEMENT(S)

16, 17, 18
C'RTT7. 1

RAFAEL E & HEIDI S CRUZ FORM 1116 PASSIVE INCOME NAME OF COUNTRY IMPOSING TAX PAID DATE ACCRUED AMT/FOREIGN CURRENCY DIVIDENDS AMOUNT IN U.S. DOLLAR~---------OTHER RENT/ROYALTY INTEREST SUMMARY OF FOREIGN TAXES PAID OR ACCRUED STATEMENT 19

VARIOUS VARIOUS VARIOUS

o.

9,022. 13. 13. 9,022. 9,035.

o.

TOTAL TO FORM 1116, PART II, LINE 8 PRIOR YEAR TAXES PAID IN THE CURRENT YEAR: FOREIGN AMT 2009 2008 2007 2006 2005 TOTAL PRIOR YEAR TAXES PAID IN THE CURRENT YEAR

CONV. RATE

U.S. AMT

FORM 1116 DESCRIPTION

EXPENSES DIRECTLY ALLOCABLE TO FOREIGN INCOME COUNTRY VARIOUS

STATEMENT AMOUNT

20

MORGAN, LEWIS & BOCKIUS LLP TOTAL TO FORM 1116, PART I, LINE 2

145,673. 145,673.

15211006 786859 CRUZ

60 2010.03060 CRUZ. RAFAEL E

STATEMENT(S) 19, 20
~RTT7. 1

RAFAEL FORM 1116

E & HEIDI S CRUZ WORLDWIDE CAPITAL GAINS WORKSHEET FOR LINE 17 STATEMENT 21

1

ENTER THE AMOUNT FROM FORM 1040, LINE 41. IF YOU ARE A NONRESIDENT ALIEN, ENTER THE AMOUNT FROM FORM 1040NR, LINE 38 ENTER WORLDWIDE MULTIPLY 28% GAINS

1,826,216.

2 3 4 5 6 7 8 9 10

LINE 2 BY 0.2000 25% GAINS

ENTER WORLDWIDE MULTIPLY

LINE 4 BY 0.2857 5,113. 2,922.

ENTER WORLDWIDE 15% GAINS AND QUALIFIED DIVIDENDS MULTIPLY LINE 6 BY 0.5714

ENTER WORLDWIDE 0% GAINS AND QUALIFIED DIVIDENDS ADD LINES 3, 5, 7, AND 8 SUBTRACT LINE 9 FROM LINE 1. ENTER THE RESULT HERE AND ON FORM 1116, LINE 17 2,922. 1,823,294.

FORM

3800

SMALL BUSINESS

CREDITS

STATEMENT

22

TOTAL

CURRENT

YEAR CREDITS

ON FORM 3800, LINE 8
A B

151.
C
D A B+C SUBTRACT FROM LINE 8 -

DESCRIPTION 8882 EMPLYR CARE TOTALS TOTAL SMALL BUSINESS PRVD CHILD

SMALL BUSINESS CREDIT 151. 151. CREDITS 8

PASSIVE CREDIT INCLUDED IN COL A

PASSIVE ACTIVITY CREDIT ALLOWED

O.

O. O.
3800, LINE 8

151. 151. 151.

o.
FROM FORM

TO SUBTRACT

TOTAL TO FORM 3800, LINE

o.

15211006

786859 CRUZ

2010.03060

61 CRUZ, RAFAEL

E

STATEMENT(S) 21, 22 CRUZ 1

RAFAEL FORM 6251

E & HEIDI S CRUZ DEPRECIATION ON ASSETS PLACED IN SERVICE AFTER 1986 STATEMENT AMOUNT LEWIS & BOCKIUS LLP -346. -346. 23

DESCRIPTION FROM K-l - MORGAN,

TOTAL TO FORM 6251, LINE 18

15211006

786859

CRUZ

2010.03060

62 CRUZ. RAFAEL E

STATEMENT(S)
r'RTT'7.

23
1

RAFAEL FORM 1116

E & HEIDI S CRUZ, ALTERNATIVE MINIMUM TAX FOREIGN TAX CREDIT WORLDWIDE CAPITAL GAINS WORKSHEET FOR LINE 17 FROM FORM 6251, LINE 29 25% GAINS STATEMENT 24

1 2 3 4 5 6 7 8

ENTER THE AMOUNT ENTER WORLDWIDE MULTIPLY

1,931,054.

LINE 2 BY 0.1071 5,113. 2,374.

ENTER WORLDWIDE 15% GAINS AND QUALIFIED DIVIDENDS MULTIPLY LINE 4 BY 0.4643

ENTER WORLDWIDE 0% GAINS AND QUALIFIED DIVIDENDS ADD LINES 3, 5, AND 6 2,374. 1,928,680.

SUBTRACT LINE 7 FROM LINE 1. ENTER THE RESULT HERE AND ON FORM 1116 AMT, LINE 17

FORM

8582

ACTIVE

RENTAL

OF REAL ESTATE YEAR NET LOSS

- WORKSHEET

1

STATEMENT

25

CURRENT NAME OF ACTIVITY NET INCOME

PRIOR YEAR UNALLOWED LOSS

OVERALL GAIN OR LOSS GAIN LOSS

CONDO - 3333 ALLEN PKWY UNIT 2606, HOUSTON, TX 77019 RENTAL HOUSE - 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS

O. O. O.

-14,427. -31,511. -45,938.

-24,529. -43,483. -68,012.

-38,956. -74,994. -113,950.

15211006

786859

CRUZ

2010.0:\060

CRUZ _ RAFAEr~ E

63

STATEMENT(S)

CRTTZ

24, 25
1

RAFAEL E FORM 8582

&

HEIDI S CRUZ\ ALLOCATION OF UNALLOWED LOSSES - WORKSHEET 5 FORM OR SCHEDULE SCH E SCH E STATEMENT 26

NAME OF ACTIVITY CONDO - 3333 ALLEN PKWY UNIT 2606, HOUSTON, TX 77019 RENTAL HOUSE - 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS

LOSS 38,956. 74,994.

RATIO .341869241 .658130759

UNALLOWED LOSS 38,956. 74,994. 113,950.

113,950. 1.000000000

FORM 8582

ALLOWED LOSSES - WORKSHEET 6 FORM OR SCHEDULE SCH E SCH E

STATEMENT

27

NAME OF ACTIVITY CONDO - 3333 ALLEN PKWY UNIT 2606, HOUSTON, TX 77019 RENTAL HOUSE - 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS

LOSS 38,956. 74,994. 113,950.

UNALLOWED LOSS 38,956. 74,994. 113,950.

ALLOWED LOSS

FORM 8582
R R E

SUMMARY OF PASSIVE ACTIVITIES

STATEMENT

28

A NAME

FORM OR PRIOR SCHEDULE GAIN/LOSS YEAR C/O

NET GAIN/LOSS

UNALLOWED LOSS

ALLOWED LOSS

X CONDO - 3333 SCH E ALLEN PKWY UNIT 2606, HOUSTON, TX X RENTAL HOUSE SCH E 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS

-14,427. -31,511. -45,938.

-24,529. -43,483. -68,012.

-38,956. -74,994. -113,950.

38,956. 74,994. 113,950.

PRIOR YEAR CARRYOVERS ALLOWED DUE TO CURRENT YEAR NET ACTIVITY INCOME TOTAL TO FORM 8582, LINE 16

? () () 1

() ~ () h ()

('I~TTrz

64

~ ~ H'~ 1<'T. 1<'

STATEMENT(S) 26, 27, 28
('I~TTrz 1

RAFAEL FORM 8582 INCOME

E & HEIDI S CRUZ. MODIFIED AGI STATEMENT 29

WAGES, SALARIES, TIPS ETC. DIVIDEND INCOME TAXABLE REFUNDS ALIMONY RECEIVED TAXABLE IRA DISTRIBUTIONS TAXABLE PENSIONS AND ANNUITIES UNEMPLOYMENT COMPENSATION OTHER INCOME INTEREST INCOME ADD: SERIES EE AND I EXCLUSION BUSINESS INCOME OR LOSS ADD: PASSIVE LOSSES SUBTRACT: PASSIVE INCOME SALE OF ASSETS (BEFORE CAPITAL LOSS LIMITATION) ADD: PASSIVE/RREA PROFESSIONAL LOSSES SUBTRACT: PASSIVE INCOME RENTAL, ROYALTY OR PASSTHROUGH INCOME OR LOSS ADD: PASSIVE/RREA PROFESSIONAL LOSSES SUBTRACT: PASSIVE INCOME FARM OR FARM RENTAL ADD: PASSIVE/RREA SUBTRACT: PASSIVE INCOME OR LOSS PROFESSIONAL LOSSES INCOME -32,382. 2,957.

360,290. 8,742. 6,204. 20,225. 11,500.

2,957.

LIMITED 1,718,182.

-3,000.

1,718,182.

TOTAL

INCOME

2,125,100.

ADJUSTMENTS MOVING EXPENSES SELF-EMPLOYED HEALTH INSURANCE DEDUCTION PENALTY ON EARLY WITHDRAWAL OF SAVINGS ALIMONY PAID KEOGH/SEP DEDUCTION OTHER ADJUSTMENTS TOTAL ADJUSTMENTS TOTAL TO FORM 8582, LINE 7 4,995. 49,000. 53,995. 2,071,105.

')n1

n

n'lne::n

f"''DTTI7

65

'D'lI.'C''lI.'C'T_

'C'

STATEMENT(S)

29
1

RAFAEL E & HEIDI S CRUZ FORM 8582 ALTERNATIVE MINIMUM TAX ACTIVE RENTAL OF REAL ESTATE - WORKSHEET 1 CURRENT YEAR NAME OF ACTIVITY CONDO - 3333 ALLEN PKWY UNIT 2606, HOUSTON, TX 77019 RENTAL HOUSE - 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS NET INCOME NET LOSS PRIOR YEAR UNALLOWED LOSS STATEMENT 30

OVERALL GAIN OR LOSS GAIN LOSS

o.

-14,427. -31,51!. -45,938.

-24,529. -43,483. -68,012.

-38,956. -74,994. -113,950.

o,
o.

FORM 8582

ALTERNATIVE MINIMUM TAX ALLOCATION OF UNALLOWED LOSSES - WORKSHEET 5 FORM OR SCHEDULE SCH E SCH E 38,956. 74,994.

STATEMENT

31

NAME OF ACTIVITY CONDO - 3333 ALLEN PKWY UNIT 2606, HOUSTON, TX 77019 RENTAL HOUSE - 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS

LOSS

RATIO

UNALLOWED LOSS

.341869241 .658130759

38,956. 74,994. 113,950.

113,950. 1.000000000

FORM 8582

ALTERNATIVE MINIMUM TAX ALLOWED LOSSES - WORKSHEET 6 FORM OR SCHEDULE SCH E SCH E

STATEMENT

32

NAME OF ACTIVITY CONDO - 3333 ALLEN PKWY UNIT 2606, HOUSTON, TX 77019 RENTAL HOUSE - 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS

LOSS 38,956. 74,994. 113,950.

UNALLOWED LOSS 38,956. 74,994. 113,950.

ALLOWED LOSS

15211006 786859 CRUZ

66 STATEMENT(S) 30, 31, 32 2010.03060 CRUZ. RAFAEL E ~Rn7. 1

RAFAEL E & HEIDI S CRUZ FORM 8582AMT
R R
E

SUMMARY OF PASSIVE ACTIVITIES - AMT

STATEMENT

33

A NAME

FORM OR PRIOR SCHEDULE GAIN/LOSS YEAR C/O

NET GAIN/LOSS

UNALLOWED LOSS

ALLOWED LOSS

X CONDO - 3333 SCH E ALLEN PKWY UNIT 2606, HOUSTON, TX X RENTAL HOUSE SCH E 1510 HARTFORD RD, AUSTIN, TX 78703 TOTALS

-14,427. -31,511. -45,938.

-24,529. -43,483. -68,012.

-38,956. -74,994. -113,950.

38,956. 74,994. 113,950.

PRIOR YEAR CARRYOVERS ALLOWED DUE TO CURRENT YEAR NET ACTIVITY INCOME TOTAL TO FORM 8582AMT, LINE 16

15211006

7R6R5q

~Rn~

?n1n_n~nhn

67
(,,'RTT'Z 'R~H'~li'T.
li'

STATEMENT(S) 33
(,,'RTT'7
1

RAFAEL FORM 1116

E & HEIDI S CRUZ U.S. AND FOREIGN SOURCE INCOME SUMMARY FOREIGN DIVIDEND INCOME STATEMENT 34

DESCRIPTION GOLDMAN SACHS & CO. DIVIDEND INCOME

AMOUNT 99. 99.

TOTAL FOREIGN

FORM 1116

U.S. AND FOREIGN SOURCE INCOME SUMMARY FOREIGN PARTNERSHIP/S-CORPORATION INCOME

STATEMENT

35

DESCRIPTION MORGAN, LEWIS & BOCKIUS LLP INCOME

AMOUNT 167,901. 167,901.

TOTAL FOREIGN

PARTNERSHIP/S-CORPORATION

FORM 1116

U.S. AND FOREIGN SOURCE INCOME SUMMARY TOTAL PARTNERSHIP/S-CORPORATION INCOME/LOSS INCOME

STATEMENT

36

DESCRIPTION MORGAN, TOTAL LEWIS

LOSS

& BOCKIUS LLP
INCOME/LOSS

3,170,285. 3,170,285.

PARTNERSHIP/S-CORPORATION

15211006

786859

CRUZ

2010.03060

68 CRUZ, RAFAEL

E

STATEMENT(S)

34, 35, 36 CRUZ 1

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